Photo: mine- it was the only footprint in the dry river bed… where did it come from?
There are plenty of articles and videos about the impact of trauma on the development of eating disorders. The attack on self-worth goes deep. For some, ‘disappearing’ is a response to unwanted contact with people. For others, it’s about misplaced shame. When someone is emotionally, sexually, or physically abused, or neglected, there is a major disruption to the foundation of a healthy view of themselves.
I don’t like ‘blame’ for how I view my mom who was one of my primary abusers. She did horrible things, but I think it was more that she was broken than deliberately malicious most of the time. My maternal grandmother also did some sketchy things when I was very young, but I still preferred being there than at home… at least with my grandparents, I wasn’t invisible.
There were traumatic events at the hands of those outside of my family, and one particularly horrific example is with my skating coach. Her husband bludgeoned their six children because he was mad she wanted a divorce. I was 14 at the time, and in another blog I wrote, the comments included many who felt the same way I did… if parents get mad, kids can get killed. I knew the oldest kid from the rink, though not well. My parents also didn’t handle it well, and told me to get over it, it had nothing to do with me. My coach was someone I could just be myself with, and she was very kind to me. I still think about that event every day.
As a young adult, I was raped, beaten, and sodomized for 6 hours before I was able to escape (he finally passed out), and police came. One of them shot the rapist in my bedroom. He didn’t die and I had to testify at the trial. He changed his plea mid-trial and accepted a 60 year sentence. He’s out on parole now for ‘good behavior’ and the stupid Texas law at the time of the crime, but he’s still my bitch until 2048. He planned to dismember me alive with one of my kitchen knives.
There were other less intense sexual assaults… one of the students at the U of IL wanted me to go out with him, and he pinned me to the dorm lobby floor, forcibly kissing me, as if that was some kind of lure. I was as disgusted with him as I was the other students in the lobby who just walked by and did/said nothing. A high school classmate groped me in the hall at school.
Having leukemia was traumatic. The intensity and duration of 20 months of daily chemo of some kind was exhausting, and the stress of the initial weeks when it was possible to die from sneezing and a brain bleed from the increased vascular pressure from a sneeze (or cough, etc) was hard. Being in the hospital for 6 weeks was also difficult, on reverse isolation. I’m fortunate in that the kind of leukemia I had (APL) is curable- not just in remission, and I’m 15 years out from the diagnosis with no sign of it being in my body for the last 15 years (first negative bone marrow test was after 3 weeks of induction chemo).
I didn’t used to think that trauma had anything to do with why I developed an eating disorder because of the way I was groomed for starvation at home, and the ongoing abuse when I was a toddler normalized it for decades- it wasn’t until after the rape that I was taught about types of abuse. Now I can see that the impact of each trauma/abuse did gut any self-worth, and that has a huge impact on who does or doesn’t engage in eating disorder behaviors. Food = staying alive. When being alive becomes too painful, there is an urge not to support its continuation. It’s not a conscious self-harm/suicidal mentality, but that’s what it becomes even if not acknowledged. I have no interest in dying, but I’m also not really living. I hope that changes.
Category: Eating Disorder
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Trauma and Eating Disorders
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Doing The Opposite Of What My ‘Head’ Says
Photo: Mine, lychees
This is so hard. I’ve never known “normal” eating, and now have the Ex-T’s “food rules” to undo as well. The entire idea of restrictive eating disorder therapy to undo the restrictive eating disorder is NOT to have food rules (other than those I have to deal with for medical issues- diabetes, kidney disease, and gout). I just want my head to settle down, and not dictate what I eat, how much, when, etc. I’ve had periods of time when it was all less intense, but for the last 4 1/2 years, it’s been pretty constant- the longest continuous time in my life when I’ve been so controlled by ‘my head’ to this degree. I’ve been in acute renal failure/acute kidney injury twice because of not eating enough in those 4 1/2 years. I have to get this sorted out. I do have a dietician, and I’m thankful for her.
Every time I make a day’s food plan, it’s all about ‘the numbers’. I don’t eat things I like UNLESS they also fit into the days ‘numbers’. Macros (protein, carbs, fats), as well as sodium (can’t go too low or my BP drops which puts my kidneys at risk, and muscle cramping is horrific). If I spontaneously eat something different during the day that messes with those numbers, I have to redo the rest of the day so the ‘numbers’ are OK again. I’m trying to figure out how to just eat stuff without focusing on the stupid numbers as much, but it’s all I’ve known for 5+ decades.
My hunger cues have been messed up for a long time. For many years, I didn’t feel physical hunger, even though I thought about food constantly and still do. I am starting to feel physical hunger again, and it’s terrifying. I have images of me eating what I want until I feel full and ending up gaining even more unneeded weight. In reality, it doesn’t take much for me to feel full. But the fear is very real. I view myself as already grotesquely overweight, even though when I see TV shows about extremely obese peoples’ weight loss journeys I don’t judge them. I just wonder what hurt them so badly that they are hurting themselves so much. I know that sounds hypocritical. I KNOW all of this is bonkers. And, I can’t just flip a switch.
I want to set up a day when my blood sugars are more stable (parathyroid hormone is wonky right now, so insulin resistance is increased), and then just try and – for one day only (to minimize panic in my head)- eat what sounds good when I’m hungry, and not worry so much about anything that isn’t focused on getting me stronger. If I make it for only one day, I don’t have the pressure to do it for longer while giving myself the chance to see that it is possible. Then, I can do 2 days, etc. In the meantime, I’m trying to have one thing every day- even if it’s just 15 grams more of something, that is against what my head wants, which is eating close to nothing, although I’m eating ‘enough’ to keep kidney function stable at this point. I do get some reprieve because of the kidney situation, but it’s not all-encompassing. I HOPE that if I can get my eating more ‘normally’ that my kidneys will do better. I am not someone who would do dialysis if it came to that.
I have found that I do better if I can avoid sweet foods in the morning. I just don’t like them, so the past 3 1/2 years of being strongly encouraged to eat yogurt and berries, kefir, or oatmeal/porridge, and the horrible sweetness of those, have been miserable. I couldn’t find a savory oatmeal recipe that sounded edible. Scrambled eggs were/are allowed, but when my blood pressure isn’t stable, or I’m in a lot of pain, it’s hard to do a lot of stuff that requires prep and/or cooking. I much prefer something like cheese and crackers, and maybe some fruit that has a bit of tang, or even leftovers from another savory meal. Many countries have soups as ‘normal’ breakfasts, and that might also be a good thing to try.
Single serving items are also helpful, though I have to be careful with prices. For frozen entrees, I have several that are budget friendly and taste good, and only require being popped into the oven or microwave. Lean Cuisine has a lot of flavor options, and for a substantial treat, I’ll get Amy’s Kitchen or MichaelAngelo’s frozen single serve entrees. With some products, I can count out the portion size-and that’s doable. I do like the flavor of a lot of different ethnic foods, so that helps as well. I do have very specific dislikes, but those are easy enough to avoid.
It’s been good to be having more fresh fruits and vegetables, though with the prices in the US, most are a luxury. It helps to incorporate them into chickpea salads, or other food ‘stretching’ meals, and keep the frozen and some canned items for more ‘bulky’ vegetable servings. Lettuce is too expensive for what it provides, so most of my salads are what I’d put on a bed of greens. It cuts down on the volume without cutting down on the nutrition that comes from the chickpeas, peppers, onion, olives, cheese, and croutons. Doing seasonal grocery lists has been useful, as have some frozen options. I could have fruit and veg with Ex-T, but with the other stuff she wanted me to get in, volume tolerance was a problem. Now, I prefer to prioritize fruit and veggies more, and ‘fill in’ with protein, starches, and fats with an emphasis on nuts, olives, and the occasional avocado or premade single serving of guacamole. It’s still a challenge not to feel too full, but I’m making little steps.
Mostly, I need to quit freaking out about the numbers at the end of the day. I don’t let myself get to a calorie level that is too scary, and that’s still a problem. Calories should only be an issue in that I get enough to fuel my body for continued healing. Not that are restricted because it’s what the eating disorder wants. -

Returning to The University and Ending Up In A Coma
Photo: online search from capefoxfcg. com
After a great six weeks working as a cabin counselor at my favorite camp, I had to face returning to the University of Illinois. I wanted to go back, but I didn’t realize how unprepared I was. My mom had also been diagnosed with breast cancer, and had started radiation, so i had to return to campus about 2 weeks before everyone else, so her radiation schedule could proceed. It got dicey fairly quickly.
Being in the nearly empty dorms was kinda creepy. I was on a different floor than my previous semester. Getting there on a Saturday made it all that much more ‘dead’. It was the female’s side of twin 12-story towers, and there were 1-2 other people on my entire floor (usually there were over 100 students on each floor). I was used to being alone at home, but not in a building that had been so bustling and full of life the previous (shortened) semester. I ended up going to campus bars even though I was underage to be served alcohol, and got plastered most nights before stumbling back to the vertical vacuum of a dorm. I wasn’t a drinker by a long shot. But I needed to numb my brain over my nervousness about being back in school after being removed the previous semester, and my former dorm mates knowing that I’d been in a psych hospital. My mom’s cancer didn’t really enter my mind, which sounds awful, but I think it was a form of self-protection.
My roommate showed up when the official dorm arrival time finally came, and we got along well. I was still technically a freshman, and it was her first semester in college. I look back now at how young we both were. But we were ready for the upcoming semester, though I tried to hide my anxiety. I continued to go to the bars most nights during freshman orientation week. I’d already been to that a year earlier, so didn’t attend those activities. I was glad to be back, but I was in over my head emotionally. Then classes started, which was a relief and terrifying. I still had academic probation rattling around in my head like a judge, jury, and executioner.
I was still on antidepressants (they never worked, but I was doing better because my eating disorder wasn’t as intense) and sleeping pills, so drinking was definitely not a smart thing to be doing. But I needed the ‘numb’. I didn’t have any thoughts of suicide. I was stressed out and not sleeping well, but was still focused on doing well in school. The time being alone before everyone else arrived wasn’t good, but it was the only option at the time with my mom’s radiation schedule.
I don’t remember a lot about the events that nearly took my life, but I do have bits and pieces, and wrote to my roommate later to ask her what had happened. I’m sure that being a teenager, as I was, it was traumatizing for her to have to deal with what she did with me.
I remember it was a Tuesday evening. I had on a red gingham short sleeved cotton shirt and denim overalls. I was exhausted. Classes were in session, and I was trying to settle into the routine again. I needed sleep, and went out to one of the bars again. I didn’t get sloshed, but I was more relaxed when I got back to the room. I was coherent enough to hold a conversation with my roommate, as well as do some homework, but mostly I was thinking about getting a decent night’s sleep.
I had a bottle of soda, and was sitting at my desk, with my back to the rest of the room. My roommate was reading on her bed behind me. I got my bottle of sleeping pills- there were ten in the bottle. I do remember taking those, but not to die. It was almost an out of body methodical and rhythmic taking a pill and putting in my mouth, then washing it down with soda. Swallow, repeat until the bottle was empty. I’m sure my roommate didn’t see anything. Not long afterwards, I went to bed.
In the morning (Wednesday), my roommate wrote that she tried to wake me up for classes, but I said I was too tired. I don’t remember any of that. When she got back from classes later that afternoon, and around 20 or so hours after I took the sleeping pills, she couldn’t wake me up. She went to the dorm floor where I’d been the previous semester to find someone who knew me then, and one of them came down to the newer room with my roommate. That student immediately got an ambulance called, and I was taken to the university student health center, who sent me on to a trauma center.My blood pressure ‘numbers’ were nearly meeting in the middle (70/60 territory), which is NOT good, and I wasn’t responding to any stimuli. My Glascow Coma Scale score was 3… next step is dead. When I got my chart later on, and after having worked on a hospital neurology floor as a nurse, I knew what I was looking at. I was lucky to be alive at all. My stomach was pumped, which also included being intubated. I don’t remember taking the bottle of antidepressants, but the bottle of 50 remaining pills was empty, and there were pill fragments in my stomach. I was sent to ICU, where they kept my blood pressure going, and dealt with variations in my heart rate. I have a vague memory of someone pulling an oxygen mask away from my face and asking if I’d overdosed, and I said no. I really didn’t think of it as an overdose at the time. I just wanted to sleep, so I’d do better going to classes.
The next clear image was when someone went towards my crotch with a syringe. I knew nothing about catheters, or having them removed, but that’s what the nurse did. I asked what I was wearing when I was admitted, because it helped me know what day I’d last remembered- I’d remembered the farmer get-up being what I’d worn on Tuesday. I also didn’t know about the charcoal they gave me to absorb the toxins, but knew exactly what impending explosive diarrhea felt like from months of laxative purging, so unplugged the leads so I could go to the bathroom. I didn’t know that doing that would look like something bad was going on via the EKG monitors at the nurses’ station, so was very surprised to see several people hurrying into the room as I was getting to the bathroom door. I got out of the bathroom, still kind of confused, and asked what day it was- and it was Friday evening. I’d been unconscious for 3 days. The red gingham shirt and overalls gave me a frame of reference for time, weird as that seems in the midst of what had gone on.
Very early the next morning (Saturday), I was helped to get cleaned up and put in a chair in front of the Saturday morning cartoons- and not really being able to follow the plot of Bugs Bunny. I knew that wasn’t right, but didn’t know why. Everything was fairly uneventful until I saw my parents out at the nurses’ station. I freaked out. I didn’t want to leave school, was too spaced out to understand the gravity of what had transpired, and was horrified that my parents were there. I’d messed up again. My university therapist was called, and she came up to talk to me, even though she was on bedrest for a blood clot in her leg during pregnancy. She kindly explained that the university couldn’t be responsible for someone who might kill themself, whether intentionally or not. I had to leave. There were no other options.
My parents had already cleaned out my dorm room, and put me between them in the front seat of the car to take me back to the psych hospital in Des Plaines, IL. That was a long 3 hour trip. I felt like a total failure. We got to the hospital, and checked me back in. At least I saw familiar staff faces, which helped a little. The next morning, my psychiatrist from the previous hospitalization came in and told me i was lucky to be alive, and that it was incredible that I didn’t have any brain damage with what I’d taken, and how long it was before I got to the trauma center.
Later, as a RN, I’d hear other nurses complain about overdose patients. They felt they needed harsher treatment in the ER if they were at all awake, to deter them from doing it again, as if it was a personal affront to the nursing staff. But I never heard one of them ask the person why they’d done it, or if they even wanted to die- not caring about what had brought that person to that point. I didn’t have thoughts of dying. I was young, did some stupid drinking, which dulled any common sense regarding the sleeping pills, and made a huge mistake. I never meant to cause the hospital folks any trouble. I certainly didn’t want my folks involved, or to leave school. My folks never asked why I did it, either. Ever. My mom had another 21 years to ask me, and my dad had another 34 years to ask, and nothing. That amplified the shame.
Things like ‘suicide attempts’ and overdoses aren’t attention seeking when they’re highly lethal without intervention. They’re a response to overwhelming stress and emotional pain. Why add to that? Being punitive is never productive with emotional crises. Compassion is free, and can change the course of someone’s life. And compassion is why I became a nurse, because of the kindness of a student nurse during the hospitalization after the OD. Change someone’s life for the better. Don’t make it about you. -

Food At My House While Growing Up
Photo: online search
My folks were always weight conscious, to the point of extreme dieting. Dad didn’t have a weight problem, but thought he did if his trousers felt a bit snug. Mom was ‘normal’, and not fat, but always on some kind of diet or going to some diet meeting. I ended up being most impacted by my mom’s food rules and bribes for me to lose weight starting when I was 6-7 years old and not at all fat.
Prior to the diet invasion into my life, I don’t remember a lot about food one way or the other. I know we had “kid cereal” when I was younger than 5 years old, because my dad liked it. Food really wasn’t an issue unless it was something I didn’t like (or threw up when I ate it- like cooked carrots, baked beans, and cold french fries). It was when the diet bribes started that my weight was constantly a part of my daily thinking. No child should be on diets that aren’t medically necessary or supervised. And offering a kid a dollar for every pound they lost (when gas was 36 cents a gallon) and a big bag of candy for every five pounds (how that made any sense, I’ll never know) isn’t OK. My mom wasn’t ‘bad’, but she was misguided by her own weight issues and wanting me to look like the beanpole kids at church. I’m built more like a brick. It would never work out. But as a kid, I wanted her to be happy.
As a family, we always had dinner together unless my folks were out of town, or at a work or church party of some sort. If my folks were entertaining guests for dinner, I got a TV dinner, which I loved ! I could pick whatever I wanted. But a ‘normal’ dinner for three would be one 15 oz can of ravioli, or sharing a box of Kraft mac & cheese (a hotdog would be cut up in it sometimes), or soup. But we did at least eat together.
My folks travelled over school breaks, and I’d stay with my grandparents (usually paternal since they were closer to our house). I was allowed to eat there most of the time, and would gain a few pounds. Being an active kid, it came off when I went back home. But my grandma always made sure she had some special things for me, and I was allowed to cook when I was in 2nd and 3rd grade, with pans she put in a certain place in the cabinet. They had “normal” food. Not fancy, but my Swedish grandma could cook and bake really good food. And it was much more nutritious than what was at home. A big treat was sardines on toast for breakfast. I loved it- and it wasn’t unhealthy.
In high school, I started doing diet competitions with classmates, and I made sure I always won. My mom had no issue with me having less than 600 calories per day (my usual would have been well under 1000). She’d buy me whatever foods the diet called for. My skating coach was never pleased when I was restricting, because I was a space cadet which could be risky with jumps and spins. More than once I fell and didn’t know why.
I don’t blame my parents for having an eating disorder. I think they did the best with their own hang-ups about food and weight. I was impacted by it, but I don’t believe it was malicious. -

Anorexia and Campus Life
Photo- mine.
Being a freshman at a good state university was overwhelming, and made so much worse by my deteriorating physical and mental health.
I was also a fairly good student back in my high school, with many college prep and advanced placement classes that I was used to, so the classes weren’t too advanced when I got to college. I loved walking around campus, even though I was getting weaker and much sicker. But I was glad for the experience of dorm life.
I was taking 40 laxatives/day (10 for breakfast, lunch, dinner, and before bed). I knew every bathroom in any building I had to walk into. Diet soda was my main source of fluids. During the week, I didn’t eat more than an apple or 1/2 of a baked potato when I had to make an appearance at meals. I ran the 12 flights up to my dorm room after ‘dinner’ (I could get by not eating breakfast or lunch because of everyone’s different class schedules). I had PE at 8 a.m. several mornings a week, and it was a ‘self-study’ exercise plan, so I jogged to attendance, and then back to the dorm for a shower. At the end of the semester, I ran 2 1/4 miles in 12 minutes- and I’m not sure how I actually did it physically.
My roommate moved out because I was too quiet. I also didn’t sleep much, and would watch one star go across the sky outside of my window, while listening to mellow music on the radio.
I saw the therapist every week, and I’m not sure that poor woman ever heard me say more than “I don’t know” to every question, and I wasn’t trying to be a smart ass- I was truly baffled by what I was supposed to be telling her. I had to drop my class hours down to 12 (dad was not happy- he was paying for 4 years, not some marathon of classes for more than that) because I just couldn’t keep up. I ended up on academic probation because of being so weak, and struggling with cognitive function. But I couldn’t see the physical changes. I still felt too fat.
On weekends, I’d binge. It was typical to have a pint of ice cream, a bag of chips, chip dip, cheese, cookies, chocolate, ramen, and sometimes picking the cheese off of discarded pizza boxes in the trash room after everybody was in their room for the night (usually around 2 a.m.), to avoid getting caught. My diet soda was a lifeline, and I didn’t want anyone taking it, so I labeled it with “herpes” in the floor fridge that held 2 liter bottles. I could only fit 16 oz bottles in the dorm fridge. Nobody touched it. It wasn’t true about the herpes, but I always had my soda.
My mom arranged for the food service folks to make me a birthday cake big enough for the entire dorm floor (80 girls? Guys had the adjacent tower). The cake was HUGE. I was terrified. It also angered me, which was a really crappy response to my mom wanting to make sure I had a cake for my birthday.
My ability to concentrate on homework was shot. I got a D in history (hated history back then), and for the first time in my life, I was not doing well academically. I passed out regularly, and was carried down the stairs to the floor with the elevator (and stretcher) more than a few times. It always made me cringe to have one guy pick me up- I thought it would take at least 2-3 firemen to carry my perceived fat ass. But looking back at old photos I was too thin for my body type. I asked a dorm neighbor if the leotard and sweatpants I was going to wear to go skating made me look fat. Her answer ” I can count your ribs”.
I became very depressed by the effects of starvation, and spent a lot of time in weird places- the top of the stairs that led to the roof (nothing else was up there, so seemed like a good place to hide), or I didn’t leave my room for anything but classes- nothing social. I was sexually abused in the dorm lobby while others watched, by a guy who was determined to go out with me. His approach sucked (it wasn’t ‘major’ but made an impact). I had to meet with the resident director every week as well, so she could keep track of where I was on the roller coaster of chaos. By the break for Winter/Christmas, I was making plans to end my life. I’ve never had that kind of depression unless malnutrition and starvation were involved.
I lasted for that first semester (not sure how), with many trips to the health center, dietitians, therapist, MDs, etc… the second semester was a short one.
More on that next time. -

How I Got To This Point Part 2: The Summer of Anorexia
Photo- El Arroyo in Austin, TX online photo
The summer before I started at the University of Illinois, I was working my second summer at a church camp I’d gone to as a kid for 7 summers (week long sessions). I loved that camp, and still consider it to be one of the most important spiritual factors in my life. Being outside and with nature is one of the biggest ways I relate to God. People lived what they believed, and it was fun.
I worked in the nature center the year before, as well as that fateful summer. The snakes, turtles, lizards, ferret, and raccoons were my responsibility. I was very self-conscious about my weight (as usual), and decided to use the increased activity at camp, along with calorie counting to get rid of what the ‘numbers’ said were wrong. I also felt I’d be largely unsupervised, which was important. That was back when women were supposed to be 100 pounds for 5 feet tall, and 5 pounds for every inch over 5 feet. That put me at about 135, which is NOT a weight where I look or feel healthy. I do not have a petite bone structure. I was also a figure skater for years prior to then, and my thighs were rock hard muscles.
I started off that summer by bringing my scale, calorie books, ‘expanding’ tablets to increase the feeling of fullness, and absolutely no common sense. Getting rid of the weight was THE most important thing for me to accomplish before having to compare myself to a university full of students. I wasn’t fat. I did have weight to lose, but I went off the rails. The diagnostic criteria for anorexia nervosa was different then. It counted the % of weight from the starting weight as the weight ‘rule’. I didn’t know that when I started out, but found out later (another future post). I lost a total of 1/4 of me in about 2 months. Now, it would be atypical anorexia. Face it- starvation is starvation no matter the size of the person.
What I hadn’t expected was an 88-pound anorexic with bulimic tendencies to be assigned to the same set of cabins I was, and became my guide to self-destruction. We became friends very quickly, and she taught me about laxatives for purging, the importance of exercising like a maniac, and how to avoid eating and nosey (concerned) coworkers. I woke up the first morning that we had campers (there was a week for staff only to get the ‘ins and outs’ of camp life before the kids arrived on Sunday). I ran down to the barn and back (2 mile round trip), and had an apple for breakfast. I felt great. I also was drinking about 6 cans of Tab per day (precursor to Diet Coke).
I lost 17 pounds the first week, and one of the counselors who went on “adventure camping” weeks (biking, river rafting, etc) didn’t recognize me when she got back the following Saturday. When people from the church I attended back then came to drop off their kids for a week long camp session, my mom would send ‘care baskets’ with body wash, quarters for laundry, and with the weight loss, a pair of rainbow suspenders to keep my jeans up (rainbow suspenders were a ‘thing’ with no other meaning than Mork wore them on “Mork and Mindy”). I didn’t feel any different, but got a ‘high’ from seeing the numbers drop on the scale.
The head honchos at the camp (direct supervisor, camp nurse, and main boss over the campus) knew something was wrong fairly quickly. They threatened to keep my paycheck unless I ate, but legally couldn’t do that. Over the next 4 weeks I lost another 23 pounds, and the nurse from the year before was in the area, and the camp folks sent me off with her on nights off, to talk some sense into me. She tried hard. But I was already hooked.
My folks came up to visit me (first time they’d done that, so I’m not sure if they were notified of the weight loss), and actually talked to me more than when I’d been heavier. Coincidence? Maybe- but for weight obsessed parents, I found it disappointing that I was ‘worth more’ if I weighed less. That was a big reinforcement of the determination to drop weight. And aside from the suspenders, they didn’t mention my rapid weight loss.
Over that summer, I lost 45 pounds altogether, and just had a couple of weeks at home before heading to the University of Illinois in Urbana-Champaign. A third of my hair had fallen out, I was freezing all of the time, I’d turn blue, and other students on the dorm floor knew something wasn’t right. When they caught me after I’d gone to the water fountain to fill my water mug, I was in a light winter coat, jeans, and 6 pairs of socks in very humid central Illinois, in late August. My feet felt cold through the socks. They called the resident advisor (more senior student for one dorm floor, for those not in the US), who called the resident director (over the whole girls side of the dorm), and they shipped me off by ambulance for a night in the university health center hospital. I had to talk to a psychiatrist in the morning. I thought they were nuts. I wasn’t thin enough yet. But, the psychiatrist disagreed, and the diagnosis of anorexia nervosa was given. In order to stay in school, and not have to tell my parents I was in trouble, I agreed to the therapist. I saw her for the entire semester, and early part of the next one.
More on the University of Illinois “routine” with how anorexia impacted me in another post. -

General Thoughts About Moving Forward After Ex-Therapist
There were never any consistent “lessons” with Ex-T (ex-therapist)- I knew her basic beliefs about eating disorders, but that’s it. She mentioned the importance of what I tell myself about myself-and that the brain hangs on to all of that, but that was about the extent of it. I no longer support many of her views and methods. While there are some valid points about the ‘confirmed negativity’ in the minds of people with many types of psychological disorders, I think there is room for other influencing factors as well. She did deal with trauma, but with me it was only discussions of what happened- nothing about what to do with it.
Some things Ex-T wrote in her book are thing I do still believe, but her “objectification” of criticism of what was going on with MY “therapy” turned into just ignoring it altogether. There was no discussion. I over-objectify a lot of things (even she said that I went too far with something that was just logical to me), but I will NOT objectify my right to emotional reactions, or how long it takes me to work through them. Only robots do that. Or sociopaths. People have emotions. They’re not good or bad- they just are.
What someone does with emotional responses is another matter. Example- when I was raped, it changed my life permanently, BUT I also knew it had nothing to do with me as a human being. What happened was because of him, not me. And, I didn’t transfer my feelings about men to ALL men because of the CHOICES and torture by one man. I was gutted that day, but I still had some great male friends and coworkers that never triggered me after that rape.
With Tabitha Farrar, there is a lot of focus on neural rewiring and HOW to do that (to be fair, Ex-T also believed strongly in this- but without the ‘how to’ part, at least with my 3 + years of going nowhere), . She has written one main book, and several smaller books on why it’s important to not give the brain any more ammunition to feed the eating disorder. What we all tell ourselves about ourself matters with mental health. Farrar also believes in the genetic component. Ex-T didn’t, at least when I mentioned it, she referred back to the term and beliefs SHE created. I do agree with her in that the feeling of worthlessness is a core feature of people with eating disorders (and other emotional issues). That’s what struck me most in that news program about her clinic back in the late 90s. I’d never heard someone who ‘got it’, and didn’t agree with the ‘control’ reason (control is shot fairy early on), fashion (most of us wear a lot of baggy stuff- not exactly runway material), or other superficial reasons.
I have a STRONG genetic ‘link’ in my biological paternal aunt who was (and I think still is) anorexic since the 1960s. She supposedly developed late-onset schizophrenia, but I think she likely has damage from decades of malnutrition that doctors simply don’t assess for, or know what to do with when it’s an adult they’re diagnosing. Adult primary care MDs don’t get educated about eating disorders or the impact of malnutrition (that’s why they do dietary consult orders, or just ignore the issue altogether). In photos I’ve seen of my biological aunt in her later life, she was emotionally connected to and interacting with those around her in a way that I haven’t seen in schizophrenics (I worked psych and nursing homes that had schizophrenic patients). She’s still very petite. Remember, only %6 of those with eating disorders are noticeably underweight.
At any rate, I wish I’d gone with Farrar’s books a lot sooner, and saved myself the psychological trauma of Ex-T. I have a lot of things to “un-do” from Ex-T’s orthorexic food ‘rules’ and cult-like manipulation and psychological control. I doubt I’m the only one of her patients to end up feeling like this when the real ‘wizard’ was finally seen after the curtain was pulled back, so to speak.
In looking at the food list she sent me (after a year of promises to do so), it’s clear that she was restricting my food- and yes, I want to lose weight to be healthier, but every other CURRENT eating disorder content creator believes in lifting all non-medical food rules to get to ‘normal’. Not more restriction. I shouldn’t feel guilty for having Special K because of one ingredient that is in it, that isn’t consumed daily, and not in anything else I eat. It’s a great source of protein, and my options for protein are limited by gout and kidney disease.
If I never have kefir again, I won’t be bothered. And it’s going to take a while to want yogurt or oatmeal again. Most things Ex-T suggested didn’t require teeth, and I think that’s because she worked with developmental stages (not a bad thing, unless it goes on too long and doesn’t involve fixing anything). A cracker was about as ‘toothy’ as it got.
My dietician wanted me on nutritional supplements years ago, even being overweight, which solidified that my weight didn’t equate to being nourished. I still have trouble justifying feeding what I see in the mirror. I didn’t want supplements, but at least I know that IF I decide to use them, the dietician (Masters’ degree) supports that. She also supports having something now and then just because I like it. I’m not used to that… from long before Ex-T.
With Ex-T, she wanted to control food- and initially, that was helpful since I was SO terrified. Just opening the fridge door would have me in tears (and she’d tell me about how she was cooking for ‘kids’- regardless of chronological age- at her house while I was white-knuckling it at home alone). More than 3 years later, I’m still very much about watching “the numbers”, especially macros, which I am stuck with to some degree with diabetes, gout, and kidney disease and their associated food limitations. But at some point, it felt like controlling what i ate was more about her having control over me– not helping me deal with seeing food as something beyond terrifying and very shameful. From a young age, food has always been associated with ‘worth’- and according to my mom, I shouldn’t even want to eat. She wanted a kid built like a toothpick… I am built more like a soda can. I’m trying to use that to help in my perception of why I have to eat. Different bodies = different needs. But we all deserve to fuel our lives… I’m just not good at that yet. -

Choosing An Online Eating Disorder Therapist
Photo- mine.
OK, first of all, if you can get professional “in person” help, please do. Things have come a long way in the 44 years I’ve been getting help on and off- from straight up psych hospitals, to inpatient treatment (medical and residential), and outpatient. Back then, if you ate, you were better (and cut loose). No matter what kind of treatment you get, be sure to get a doctor on board, and especially a dietician. If you go through a program, those folks and therapists are part of the program.
There’s a much better understanding about the impact of restricting food and compensating (exercise, purging, skipping food, etc), and more intuitive ways to manage food, though I do think a food plan is helpful at first and can help ease the guilt of eating if someone else just puts it in front of you. I never had that kind of experience outpatient, and with inpatient, stuff just showed up whether or not I wanted it, which was appropriate for that level of care. MANY of the symptoms of anorexia, or any ongoing restriction, are the direct result of starvation and malnutrition. Many family members are recruited to supervise meals in the beginning. That’s a good thing, though terrifying. It will help things move along better in the early months. With improved nutrition, the eating disorder thought patterns and obsession reduced, though I know of one man whose entire family went into the food service business after surviving a concentration camp. https://psychiatry.duke.edu/blog/starvation-experiment
Refeeding syndrome is serious, and needs medical supervision to monitor specific chemicals/electrolytes via blood tests. Refeeding done wrong can be fatal, so get some help with that. It happens in any size body- I’m in a larger body, and my dietitian and ex-therapist both told me the same thing… no exercise, only up 10 minutes 3 x a day (laundry, trash, mail) unless getting food or using the bathroom. I’m still not allowed to exercise, over 3 years in. Mostly, I slept between things I had to eat, because my body was absolutely exhausted. If your prospective (or chosen) therapist doesn’t understand refeeding syndrome, find one who does if possible.
Look for the therapists’ online reviews. Google them. Check out their social media… in other words, vet the hell out of them. If there is anything questionable move on. Don’t get lulled into some disaster because you’re desperate. Try to get with someone in a group of therapists (online mental health sites that match therapists could be of use). If you find someone and things don’t work out, CHANGE therapists. They work for you- you are employing them. And that means you can fire them. I don’t mean for asking you to eat 2 grams of butter or an extra ounce of banana. I mean violating safety and ethical issues, and/or abusive or manipulative behavior. When I was first on disability, I must have ‘test-driven’ (meet-and-greet type appointment in person) about 4-5 therapists before finding one that was compatible.
Ask about how long they’ve been treating eating disorders, and what their philosophy is about eating disorder treatment. Do they support “all in”, or are they regimented ? Do they understand that size doesn’t matter, and someone who is overweight can have just as serious health complications as someone who is underweight? Even someone who is obese can have bradycardia, hypotension (low blood pressure), feel cold, have lanugo, be unable to sleep, pass out, etc. You are “sick enough” if you life is deteriorating because of your eating disorder. If al you think about is food and how to avoid weight gain, you have a problem. Especially for adults, primary care docs don’t get any education about adults with eating disorders. I’ve gone years with overt symptoms but because I’m ‘fluffy’, I was told to lose weight. NO problem ! Until it caused acute renal failure twice in the last 4 years.
If you have a therapist that micromanages every food imaginable, without the person having any risk factors for eating that food, find someone else. You should never feel guilt for eating what will get you well, and that will be different for everyone. Yeah, in the beginning, you’ll probably have to put up with some routines that can be very scary initially- but that’s to help get you out of acute starvation so your body can begin to heal from the damage caused by restriction.
The fear around this WILL decrease.
I was horrified when my ex-therapist asked me to eat 3 ounce of cheese ! WHAT? That was 3 servings in my mind- and cheese… that wasn’t safe at all to my head. But how can one designated serving size be what is right for every body out there? A child needs less, an adolescent needs a more, an larger frame adult needs more than a smaller frame (unless in weight restoration), active folks need more than couch potatoes, and someone who is overweight by xx pounds will be unable to lose weight unless they eat enough… that’s right. of us who have been chronic dieters and anorexic/atypical anorexic, and gained weight because of jacking our metabolism all to hell, need to eat more in a LOT of individual cases before our bodies feel ‘safe’ that food isn’t going to be scarce again. The body is designed for survival and keeping things as balanced as possible.
Does the therapist have set hours? What about what to do in an emergency situation if the therapist isn’t available ? Does this therapist travel a lot? Do they have other projects besides being a therapist? (I’d stay clear of them). Can you pay per session? Is payment funneled through an online wire transfer service? OR can you pay with a credit card (some recourse if things don’t work out)? Will your agreed upon appointments be set for a specific day and time, or is it more casual or unpredictable? You have to decide what you think is important. In the early months, consistency will be very important.
If you find information that isn’t positive about a prospective therapist, find another. There will always be critics, but if the majority of reviews are not good or there’ve been legal issues, that is a good indicator that you need someone else. -

Figuring Out A New Normal After Toxic Eating Disorder Therapy
I can’t begin to explain how hard the whole food thing has gotten (again) with the mess left behind from therapy hell. I’m still working on it- and doing what I can. I don’t think she has any idea how her words- or more importantly the LACK of words- can crush a mind that is already set on “worthless”. Or she simply got what she could out of me (money), and doesn’t really give a rip now. I know it’s not about me- I get that logically. But my head is using it to make life more hellish. My head can override logic in a nanosecond when it comes to the eating disorder.
For all of the talk about not restricting, when I asked her what to do when I felt hungry (this was about a year + ago when I started feeling physical hunger again- took over 2 years), she told me to eat veggies and rice cakes… in other words, triggering DIET foods, but telling me NOT to diet- WTF? Tells ME not to restrict. WTF are rice cakes good for? Compressed packing peanuts? She suggested chocolate covered rice cakes….. seriously? It’s not food, and violates decent chocolate. And it’s a huge trigger back to the late 90s when I relapsed then. Being hungry terrifies me.
Everything in the videos from people who have GOOD ED recovery advice (Tabitha Farrar, Elisa Oras, various recovery vlogs) says that even atypical restrictors get ‘extreme hunger’. Body size is irrelevant (less than %6 of people with eating disorders are medically underweight- and some who are technically overweight are the size their body type is healthiest at). They say to let it happen, and eat what sounds good. It won’t last forever. But I just freak out, and drink more water.
https://www.eatingrecoverycenter.com/resources/eating-disorder-statisticsI am terrified to eat when I finally DO feel hunger, and the “anti-diet” folks ALL talk about eating what sounds good, and however much feels right- that after decades/years (whatever it is for an individual), the body wants to consume what it has been lacking. Veggies and rice cakes are 2 food groups to restrictive eaters. It’s MORE RESTRICTION. It’s not stuff people who don’t restrict spend much time eating, at least without being under duress.
Then add all of her damn-near-orthorexic-rules about additives, types of food, potentially problematic foods (for disorders I DON’T have- bad enough to deal with diabetes, kidney disease, and gout- no need to borrow trouble), and I didn’t feel that I could make a right decision…. but I guess that was the point. Make me depend on HER to tell me what to eat (she wanted to take control again last Spring)… but she’s nowhere to be found most of the time, so how was that supposed to work? I eat as cleanly as the US food supply and my wallet allows… but in the US, toxins are ingredients, and quality is expensive. Hell, cheap stuff is expensive.
I just want to be ‘normal’… and lose weight that I don’t need (BMI charts are bullshit- made for men, and no differentiation between fat and muscle weight- I want to feel better). I could ‘live with’ how I looked after I got back from California (1996) after that treatment center. I lost more after I got home, but it was OK- I was eating, working, and hanging out with friends. Like a real human. I was still very conscious of what I ate, and avoided eating around others for about 3 years (except to ‘look OK’ at the drug/alcohol treatment place where I worked, that air-mailed me to CA after a formal intervention). But I was managing.
While my dietician is telling me to put tube feeding supplements through the tube when needed, I still have “too fat to eat normal food when hungry” barreling through my head. I’ll see my dietician in about a month. She told me that in the meantime, if something sounds good, eat it- even if it’s not uber healthy. It’s OK to enjoy food just for the hell of it. And that sounds good, but triggers a lot of guilt. I hope to eat an apple cider donut later- it’s on the list for today, and I don’t want to chicken out.
I wanted to believe ‘good’. I wanted to believe that the therapist I saw on TV in the late 90s still existed. I knew she had helped a lot of people. I didn’t want to believe any of the negative press (there’s a lot of it online). But I think I know now why people died after stopping therapy with her (many relapsed, though since some left treatment before- or after- their ‘stages’ were completed, they’re not really known about other than the more famous ones). The inconsistent contact, not calling when she said she would, taking others’ emergency calls but not mine, “breadcrumbing”, etc take a huge toll emotionally. It’s the default ‘setting’ in my head to cut back on food. It’s been mass chaos and confusion. She’d blame it on not finishing up all of the stages (I was stuck in Stage 2 of 5)… but how does someone do that when she’s MIA and might not call for a month at a time, but wanted control over food again? I would have had better input by throwing darts at a list of food. Or just pointing to something in the freezer or fridge, but that would lead to an ongoing internal dialogue about the horrors of whatever I picked. Thank goodness my dietitian is easy to work with, and backs up her recommendations with a Masters degree in nutrition, experience with eating disorders, and sound science.
Nobody will write “She avoided nightshades” on my tombstone.
https://serenity-sessions.com/breadcrumbing-psychology-how-to-stop-chasing-emotional-crumbs/ -

The Physical Torment of Eating Disorder “Recovery”
I’ve been at this for 2 years in my 6th decade of life, and it’s been hell. Some of that is from the gross ignorance of the medical field in regards to nutrition and assessing for eating disorders in someone who isn’t so thin they’re see-through. Some of that is from not knowing anything except restriction from the age of 6 when my own mother bribed me to lose weight when I didn’t have anything extra on me. Some of that is from nobody connecting the dots because I’m farmed out to so many specialists that never talk to each other (or read the other docs’ notes) that I’m the one stuck with being my own primary care health professional (thank God I went to nursing school in the early 80s when we had to know things, not just look them up- and if we couldn’t perform the skills for that class, we didn’t pass; we were ‘floor ready’ the day after graduation, even if we still had a lot of experience to gain). And, I think a lot is because most doctors now just don’t care- I’m something to get checked off of the to-do list for the day.
Physically, I’ve put up with the bloating and pain of eating more for this last 2 years. The first six months weren’t as bad as they are now, because I finally know how much I need to eat in terms of numbers, and am doing my damnedest to get there- but at what cost? A 5 oz container of cottage cheese had me bloated up to the point of triggering the dysautonomia that has a huge impact on heat regulation. But, when the 200gm baked potato was done, I shoved it in along with the cheese, bit of butter, and sour cream to get the ‘numbers’ up (while not risking going over on protein because of kidney disease- having to figure all of that out in advance so it’s not all used up during one part of the day), and spent the afternoon wishing I was a puke pro, because of the discomfort that has lasted for hours, as well as massive discouragement in not doing better after 2 fucking years.
When I’ve been to the collection of doctors I’m required to see to get meds renewed, continuous glucose monitor supplies, etc, they ALL see the tube that’s been hanging out of my face for 2 years to be sure I can get enough water in to keep my kidneys from more damage, and yet not a single one has ever bothered with any nutrition related questions. Not one has offered to help with a prescription for supplies (so I pay out of pocket for everything on a disability income). I probably need to see a GI doc, but the last endoscopy done with the local group of GI docs (and one very snarly nurse practitioner), the endoscopy anesthesiologist gave the propofol from across the room, in the port on the IV tubing about 5 feet from my body, so when it got to me, it was diluted to the point that i got drowsy, but was awake the entire time. The nurses tried to tell her that I was awake, but she muttered something about my gag reflex not being impacted any less with more propofol… it wasn’t my damn gag reflex- I HEARD AND FELT everything. So, I’m debating on which is worse- dying from starvation and kidney failure or seeing another doctor. The latter seems suicidal by commission.
I’m angry about the level of self-hate that continues, but nothing anyone has said has changed that. I have a therapist who understands eating disorders very well (arguably, someone who understands the root cause as self-hate, and has ‘gotten it’ longer than anyone else I’ve heard of since the mid-late 90s; clue- control as a reason is BS, and it’s not about skinny models/fashion- it’s about not feeling worth taking up space on the planet), and a dietician who is also very knowledgable. Both are very easy to work with. I’m lucky in that regard. But at what point is it more masochistic to keep this up? At what point is it more humane to just go back to how I was, and deal with the consequences? If it were my dog that felt this bad on a regular basis, I’d never forgive myself for not letting her go peacefully. I don’t have any interest in dying. But this isn’t even hardly living. I exist. I have stuff I need to get done, but the discomfort from eating, as well as other physical pain keeps me unable to do more than the bare minimum most days. I feel totally defeated- and I’m ashamed to even mention this to doctors because I’m not a stick insect. I have weight to lose. I’m told I have to eat more to get my metabolism up so I lose weight naturally. For someone who has NEVER eaten properly because of how food was handled at home, eating more is beyond painful. It feels inherently wrong because of inflicted shame regarding food and eating. I know that part is my ‘head’ – but that doesn’t mean that the physical torment is worth it, or somehow not ‘real’. If this was the first 6 months, I’d be (and was) more tolerant. But now, it just seems like more self-hate to keep doing this. And, I’ll be told that’s my eating disorder. So, why say anything more. I can’t think of anything I haven’t already said.
** image isn’t mine; no copyright infringement intended. If you want the image removed, please leave a comment** -
White-Knuckle Death Grip
Since things got worse during the week of Halloween when I had 4 appointments (a lot for me), with the resulting and ongoing increase in physical pain, eating got really bad. It hurt too much to cook (in a kitchen without a lot of space at the moment), and eating seemed like more of a crime than a way to stay alive. And that last part is becoming the bigger battle. While I don’t want to do anything to myself, I pray that I won’t wake up. I don’t know why I’m still here. I’ve been disabled for 20 years- I’m not worth anything in any meaningful way.
I’ve been dealing with this shit for more than 50 years, and for 43+ as someone who had been diagnosed with anorexia in 1981. I was actively restricting on my own, and at the hands of my parents, for a longer period of time than that. I’m SO tired. I am getting help, but when things got bad with pain that week of Halloween and early November, something happened in my head. I started losing hope. Add to that, the ‘natural’ degradation of mental functioning with restriction (which was already very well established), and I’m more of a mess than usual.
I have times, usually in the evening, when I feel like I’m not well in a very real, physical sense – and it’s terrifying. But it’s even more terrifying to consider going to a hospital where I can almost hear “nut job” and “looney tunes” from the hypothetical hospital staff (I’ve been treated very poorly at that place in the past- though admittedly, they’ve been MUCH better than they were in the early 2000s when physically, the seizures and dysautonomia were a huge issue (still are), and my boss would send my to the ER by ambulance. They hated me at that ER, and it showed, even though I never asked for anything. I didn’t want to be there, either !! But now, if I need help, I’m not likely to go look for it eagerly. If anything, it scares me to death- if it only would for real.
But, if I aim for anything besides 2 8 oz lowfat kefirs and 2 bottles of 15gm protein water (no sugar or fats), it’s more than I can do now. A year ago, I was getting to the kitchen regularly, and while I didn’t want to eat, I could make it work well ‘enough’. Now, it’s a shitshow. And, I’m scared. I’m hanging on to whatever I can just to suck air, and I resent it.







