Atypically Recovering: On My Own No Matter How This Goes

Tag: HDRM

  • The Idea Of Eating More Feels Like I’m Jumping Off Of A Very High Bridge

    Image: Online search; not mine

    I’m still thinking about the HDRM way of doing recovery, and in my nursing brain, it makes sense. My eating disorder brain is going apoplectic. I’ve been struggling with food intake for a long time (starting when I was still with my ex-therapist, after getting to a bit more of a mechanical vibe to eating, but never getting to the goal calorie target). I WANT to rip the bandaid off of the fear of food, and yet I don’t know how. I’ve thought of challenges to ‘break me in’ to eating more, but haven’t been able to do that.

    I’ve thought about trying to eat one meal in the higher calorie ‘zone’, but freeze up when I try to figure out what that would look like. I’ve thought about a single day of “whatever sounds good”, and suddenly nothing sounds even tolerable. I’ve thought of eating old favorite foods, and that doesn’t happen either. I’ve told myself that I can stop if it’s too hard, so my head has an ‘out’, not that I’d want to stop if I was doing OK, but to reduce the pressure to be ‘perfect’.

    The ED voice has gotten louder, and I’ve gone backwards. Calorie limits reign supreme. I’m back to single ingredients, fruit cups, and the occasional frozen sushi (thawed, of course) or stuffed grape leaves. The ex-therapist offered to help again, but I am still not trusting any of that process after 3 1/2 years did nothing to get me well. I got more food in- more than in the rest of my life for that long of a period. And it doesn’t feel great, but it doesn’t feel great to be sliding backwards, either.

    To be honest, I quit trusting the former process after I was asked to pay double for six months for more intensive contact with the ex-therapist, and within a week or so, she went MIA with a new patient who moved in with her, and left me wondering where in the hell everyone was for over a week (this was after daily contact of some sort, either a message or call), and got in contact with a patient who was further along than I was, and she let me know that everyone was OK, but there had been an unexpected situation (turns out that was the new patient ). So, other patients were set off to the side, and I was one of them.

    Though I’m no longer a patient, there has been some email contact, which is benign enough. The ex-therapist suddenly found several emails from many months ago. I wonder why it took so long to see them. If she had, she wouldn’t have had the “I didn’t know you felt like this” reaction. I’ve been telling her for months what the impact was on me, as well as prior to the final 9 months. And she didn’t even see the emails. She always saw the ones regarding money.

    When I disagreed with her on a specific topic that she’s brought up before (and when I disagreed, she asked “what the fuck is wrong with you?”- so therapeutic), coming from totally different frames of reference, this is a direct quote from that email – “you have seen some horrendous things that  may have challenged your mind about what was right or wrong ” …. SERIOUSLY? It’s MY flippin’ opinion. MINE. I get that. NOBODY tells me what I’m thinking is wrong just because it disagrees with them. What I saw that related to that topic (patient self-determination about when they ‘opt out’ after debilitating and unsurvivable medical diagnoses) was the gift of being allowed to go in peace, like we do for our pets when there is nothing left to be done other than to extend the final kindness. She insisted that everyone wants to live (speaking from a mental health vs medical POV), and that simply isn’t true. I’ve known too many people who have opted out AND who have had to suffer until the bitter end with no relief in sight from both medical and mental heath diagnoses. I’m not saying I like the idea of people being so desperate for peace that they off themselves, but I get it. Nobody wants to hurt indefinitely from mental illness, either. But somehow I’m morally wrong… ?

    Anyway, I’m still working on finding some way to try HDRM, and have sent the basics off to the dietician I used to see for her opinion, and I’m sure I’ll hear back. But I do know that HDRM follows the same principles as those I watch on YouTube who have gotten well. Like ALL of them. I think it sounds good from a research and scientific info I’ve seen. There does need to be enough calories for organ and tissue repair. Now to work on the terror of those calories. The folks on YouTube had weight to gain, though HDRM says that’s not relevant to needing calories for repair. I still have a lot of trouble justifying feeding what I see in the mirror.

  • I Found Something Interesting… A Final Chance?

    Photo: online search for free photos; not my photo

    https://www.edinstitute.org

    I came across a short video by someone on YouTube that I respect and find to have very solid information on healthy eating disorder recovery. She talked about the Homeo-dynamic Recovery Model (HDRM). The link above goes to the main website for this model, and has a LOT of articles and research (able to be duplicated, and conforms to the scientific method of research). It’s been very interesting, and I sent the links to the dietician I used to see for her thoughts- I will hear back from her after she’s had a chance to review the materials.

    BUT, something this model goes into more detail about is the amount of calories needed to repair organs and bodily systems. I’ve never made it to my maintenance calorie goal, and the MINIMUM I’d need to consume for organ repair is about double what I’m struggling to get in now. And I’m terrified of the weight gain that is inevitable with that. But I’m also intrigued at the idea of organ repair (especially my kidneys). The minimums are non-negotiable (though this is for adults in the community who are responsible for themselves) because with maintenance, there’s nothing left for repair. It makes sense, and it’s scary.

    Because of medical issues (diabetes, chronic kidney disease/CKD, and gout), protein amounts can’t go up with the calories, so that means a lot more carbs, and a LOT more fat. The same dietician ‘liberated’ peanut butter about 6-7 years ago when she told me I was under-eating and that in order to burn fat, I needed to consume fat (talk to your own healthcare provider for what is right for your body). So, that means that I’d need a lot of nuts, nut butters, olives, coconut, and avocados/guacamole. It’s something I need to work out like I did with the old diabetic exchange lists, and modify it to do this.

    The thing that keeps sticking with me is the term “homeo-dynamic” instead of homeostasis- and that makes so much sense. While the body tries to maintain a state of homeostasis, it’s a constant ‘living’ adaptation to conditions at the time, and therefore more ‘dynamic’ and not ‘static’. It’s acknowledging that there isn’t some constant state, but a continually sensing and correcting all that it can when something is out of whack. Anyone who has been abusing their body is out of whack. Damage has been done in varying degrees. By acknowledging that damage needs more calories to repair, and that the body is constantly adjusting to get to an optimal state, this makes sense to me.

    It’s an offshoot of the Maudsley Method, that has been around for ages and has research linked to it. Most of the Maudsley Method patients are teens or young adults still living at home with family based therapy at its core. HDRM is designed for adults who are not in hospital or treatment centers, and able to make decisions and monitor themselves, as hard as that is. The one non-negotiable ‘rule’ is the calorie ‘minimums’… there are no maximums, which terrifies me because of being in a larger body to start with. But if it could repair some of the things that I’ve trashed with 50+ years of restricting/being restricted? That’d be such a win.

    I’m thinking of challenging a single meal, or a single day, just to get an idea of what it would be like. I don’t have good volume tolerance, and would have to pick foods that are calorically very dense- sounds like a definite first world problem, but it’s incredibly inconvenient, and when the bloating gets bad, it’s painful. And the eating disorder thoughts will be brutal- that’s a given. But I’m willing to consider a different way of looking at things, especially when one of the YouTubers I respect used it herself, and is now well and in her second pregnancy.

    I don’t have much to lose in trying, other than being freaked out when gaining a bunch of weight. I have to tell myself that I can stop, because feeling backed into a corner isn’t a good place to be. And also keep telling myself that once damage is repaired, my body can turn its attention to what my natural set point is, and where my weight is supposed to level off. So, I have work to do to figure out how much of what foods will work within the medical restrictions, but I’ve had to do that before.

    There’s also a book with all of the articles in it (good for highlighting and making notes):
    “Recover From Eating Disorders” by Gwyneth Olwyn

    Article on calorie needs from the EDI site:
    https://www.edinstitute.org/orientation-basics/food-is-the-foundation?rq=minimum%20calories