Tag: EDNOS

A closing drawbridge and a silent cry: too much; too big

 

A closing drawbridge and a silent cry

Eating disorders and personality disorder

My body becoming too much

WARNING: this post contains potentially triggering content on the topic of eating disorders, weight, body image and emotions. Please proceed with caution. Please note that in this post I express my distressed thoughts about my body and the relationship between my body, needs, emotions and relationships. I’m aware that a lot of these thoughts are part of my personality disorder and historic eating disorders. I am not advocating or encouraging these perceptions and feelings but describing what the process of trying to live with my body and face emotions is like. I think the stage of therapy I’m going through is bringing a lot of this distress to the surface. 

My body is changing. It’s out of my control (or so it feels, though the angry punishing eating disordered voice in my head says it’s me that’s out of control – disgusting fat b*tch – and my own disgusting failure).

I have gained so much weight in the past 2 years. I have tried hard in the last few weeks to lose and done all the things that used to be my trusted go-to solutions, with the exception of using illicit medications. I have failed and no matter that I succeeded in restriction, my weight has hardly dropped. If anything, now I feel more out of control. Sometimes I wonder if any of it is to do with being in my 30s now (quarter aged spread instead of middle aged spread?!) and my mobility being poorer with so much physical pain just now.  But that does nothing to justify the gain or calm me. Many people taking the medications I take report weight gain as a side effect even when restricting.  I think it increases my appetite but I know so does my need for comfort and my lonely emptiness and my…feeling. Feeling that’s dangerous and unchecked and explosive.

Anorexia meant I was never alone. I was cold and numb and empty and hurting, but needs and unbearable feeling stayed where they belonged and I dissociated, living somewhere whiter, higher, safer, always with the twisted pleasure of bitter success in my spiral to greater protection and greater weakness. Anorexia was my companion, that reassured me all would be well if I did not deviate from this path,  spurring me on with wild energy to control and deprive and make dangerous need and demands unreachable. Soon enough I would detach and dissociate totally then maybe disappear.

Anorexia left me. Abandoned me. I failed yet again. Just like my friends, even my family, my protector and guide left me. Found out I was a vile disgusting greedy failure, undeserving of that whiter place. Anorexia too abandoned me, and sped away to a place I can no longer reach, now that it is proved yet again that really the evil inside consumes and demands and if anyone else thinks differently, it’s only that I’ve tricked them into staying and caring. They’ll leave soon, when they find out.

I could take it if it were only for my protection that I needed my friend anorexia. But the thing is, it was to protect everyone else, first and foremost, from the danger and “too much” “too big”that I am. Without my friend I hurt beyond control and I hurt others beyond control.

I look in the mirror and I’m frightened and recoil from what I see. I wish I could rip myself away from the “too much” in the presence that I see, hating every part of the space I occupy, the weight, the body that absolutely does not seem to fit together right and screams too much, too much. I cannot escape. I cannot get rid of this body and these needs. I cannot stop what it contains, the out of control, the demanding, aching. … alone without my friend to starve and cut and numb and leave this place, I cannot stop the damage I will cause to everyone I so care for and so wish to save, protect and love.

Ginny xxx

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A closing drawbridge and a silent cry – Eating Disorders and Personality Disorder – #1

A closing drawbridge and a silent cry – Eating Disorders and Personality Disorder – #1

Protection in emptiness

Eating Disorders and Personality Disorder

Chapter 1 – Introduction

I’ve been talking with a couple of people recently about eating disorders, eating difficulties and weight. Also, a kind reader commented that it was of interest to read a previous post in which I discussed some of the ways in which eating / not eating was (and at times still is) a coping strategy for me – a harmful one, but nevertheless a way of coping with something even more terrible to me than the eating disorder itself. I’d been planning to write more on this at some point and these comments have encouraged me to post on this topic now.

There are a couple of points I wish to make clear in this introductory chapter and I would be very thankful if readers would visit here before reading any of the other chapters in this Series.

Firstly, I want to make it explicit that my intention in this post (indeed any post on this blog) is not to promote eating disorders, food restriction, purging or any of the actions or thought processes that form part of them. This post and this blog are not “pro-ana”, “pro-mia” or for “thinspiration”. These terms are painful to me to write because I know just a little of the raw emotions and suffering that go along with them, for those struggling and their loved ones. I hope that there is nothing in this post that would come across as promoting starvation. Though it is something we may use to try to cope, it does immense physiological and psychological harm to us and I really, really hope that readers suffering in this way are able to get regular, face to face, professional medical and psychological help and support. I know how hard it can be to access that, both because of how hard it is to ask for help and because there may be so little specialist treatment available, with such limited criteria to access it. This is really painful and it’s a topic I will write on during the course of this Series.

In these posts I discuss and share my personal past and current experiences and feelings. Almost certainly they are not the same as those of the next person who has/had eating difficulties (although some of the themes I’ll explore I have heard other people with eating disorders talk about as well). I think it is important not to be afraid to discuss the reality of eating disorders and how they affect someone across their life – that is, across all areas of their life and often across many years as well. I think part of not being afraid and being able to find a way to recover from disordered eating is acknowledging this impact and the factors which may have been involved in the disorder taking hold and continuing.

Part of this process, for me at least, involved admitting that not eating, purging and so on and the state I attained through these things, did serve a purpose. Perhaps that is horrible and shocking. Possibly it is no longer as horrible and shocking to me as it might otherwise be, because I have gone through years of difficulties with eating, weight and body shape myself and I have also known many people with severe eating disorders.  However, I do know, and share the feeling in myself, that it is a very sensitive topic.

I hope that acknowledging the purpose and even “need” for something that the disorder gives in a sufferer’s life, is a way to begin to understand the person and what will help them best to heal and walk the path of recovery. I believe that unless we find another way of reaching what the eating disordered state provided, or an alternative means of living, it is completely impossible to break out of the disorder to continue to exist without it.

The second thing I want to make explicit at this stage is that by talking about a “need” for something the disorder gives, I do not wish to imply any blame on the sufferer (or anyone else) or that it is anyone’s fault or choice to be ill. I state vehemently that it is my belief that nobody with an eating disorder chooses to be ill or should be blamed for it. I believe we are incredibly hurt in a way even deeper and harder than the disorder itself shows.

It is cruelly true that whilst there is no choice or fault in the illness, great strength is needed in the sufferer to contemplate breaking out of it and reaching for another way of living.

I am not yet sure quite how long this Series will be and I am open to any questions or comments readers may have. I would love to hear from you. Especially as this is so sensitive a topic, I would really appreciate you asking any questions on things that are not clear or you sharing your own experience and thoughts, which likely will be very different from mine.

Please do leave messages or questions in the “Comments” section. Sometimes I am slow to respond to comments because I have poor internet access and I am very sorry for this. I am not deliberately ignoring you when it seems that I take a long time to approve a comment or reply. I do read all you say and I am very thankful that you take the time to visit this blog and to write. I hope that soon in the New Year I will be able to set up better internet access and thus reduce these delays.

As always, thank you for reading.

Ginny xx

P.S. The title of this series was inspired by The Killers’ song “Dustland Fairytale”. I In the final chapter I will explain the meaning I intended behind the title.

PD and ED – some thoughts about personality disorders and eating disorders

The majority of other sufferers of personality disorders that I have met with, as an inpatient and in the community service I go to now, have difficult experiences surrounding food, for example, having diagnoses of anorexia or bulimia, struggling with fluctuating weight, punishing themselves with food-related actions (starving or making themselves sick or bingeing, or deliberately eating foods they are allergic to in order to provoke a painful physical symptom) and so on.  This is just an observation from what I have encountered and there could be many factors involved – for example, issues around weight do seem to be on the up in the UK (or at least more prominent in media coverage?) and the majority of people I know with personality disorders are women, amongst whom eating disorders are also more common.  However, it did get me thinking and resonate strongly with my own experiences of food and disordered eating and of working in an eating disorder service.

I think food is tightly bound to feelings of anger at self or at one’s own uncontrollable emotions, and makes an effective – though it hurts to use that word – form of self-harm.  When you have thoughts like: I’m so disgusting I don’t deserve to eat / don’t deserve good food only rubbish, I do not deserve to care for myself so I only eat junk, I hate my body for making these demands [to eat], go on you disgusting bitch [I say to myself] look what you’ve done you greedy pig, now get rid of it, throw up til your throat bleeds….you’re foul, you’re disgusting, look how much you’ve hurt everyone, starve and make sure it hurts……. Those kind of thoughts; or even just being too low in the darkness to respond to the basic need for nourishment.

When my eating was the most disordered, I didn’t get specialist help or even much acknowledge the problem in the worst times, despite the efficacy of the function it was serving for me.  I was also blind to it.  My mother (in part because of how her thoughts were twisted by her own sickness) also prevented me from accessing the help that my GP desperately wanted me to get. Now I know that I was underweight enough to fall into the severe anorexic weight range where dire physical consequences were a risk.  My periods stopped and I suffered damage to discs in my back during this time.  (More on my own disordered eating in another post.)  This was long before I was diagnosed with personality disorder (my eating disorder first started when I was about 14) and it is only now, nearly 15 years later, that I am acknowledging it and can articulate what its functions were.

The other day I spied a leaflet for carers in the community service I’m part of, which discussed some of the signs of personality disorders.  “Eating disorders” was actually specifically listed as a “symptom”.  This struck me in particular because personality disorder often occurs jointly with other psychiatric diagnoses but these would not be classed as a “symptom” of personality disorder.  (For example, many people with forms of personality disorder also have bipolar disorder, but bipolar would not, at least to my knowledge, be classed as a symptom of personality disorder – it is a different diagnosis which someone may have at the same time.)

I would agree that struggling to feed myself well and at times, actions that would be classed as eating disordered behaviour, are tightly related to my emotional instability, lack of control over strong emotions or thoughts that are repulsive to me, and the need to punish and hurt myself.  So yes, I would say these are “symptoms” of my personality disorder.

I talked to two friends about the leaflet I had seen – both are highly experienced in the treatment of eating disorders.  One point they made was how much eating disorders are a sign of something else painful.  It’s often thought that once someone’s problems with food and weight are treated, they are “all better”.  However, that is very much not so.  The eating disorder is often masking, indeed a mechanism for coping with, something else.

It could be numbing, or controlling.  Overeating could comfort, suppress, bury, emotions.  Starvation, I think, ironically consumes; the hunger that gnaws painfully eats away other feelings and leaves a blessed numbness.  Thinking back to my own times of starvation, I have to admit that it was, at the very least in a significant part…. fantastic.*  I was wrapped in a protective, protecting numbness, for long periods.  (The times this cracked were utterly terrible, but the times it lasted froze me in a lighter, safer state, so it seemed.)  I will explore more of this in another post.

One struggle in personality disorders is that our emotions may, with less stimulus than it ordinarily takes, reach an unbearable high where we cannot cope or think, where there’s only fear, upset, panic, darkness, anger, sadness… or much more occasionally, extremes of joy (I am not sure why the extremes of positive emotions are so much more occasional.  Perhaps do they just trouble us less as these emotions seem more acceptable, and therefore we remember these extremes less?)  In these extreme states we can’t think, we don’t act rationally, our memory may be affected, and we may take extreme actions like overdoses, self-harm, suicide attempts, and so on.  Then it takes longer to come back down from that extreme state to “normal” – the level of emotion where it is possible to cope and function and think – than it ordinarily would take.

So I think one interaction of eating disorders with personality disorders could be this.  First, the eating disorder may serve the function of numbing emotions in the first place, so that those dangerous high extremes are not reached in the first place.  Second, it may serve the purpose of bringing us down from the extreme, with their numbing, consuming, controlling effect.  It’s similar to other forms of self harm.  When I am in extreme distress and I cut, for a brief time, it deals with the emotion or makes things feel safe again because I can be sure I’m hurting myself, not someone else.

These are just my thoughts and I would love to know more about research into this.  I wonder how much there is.  I have read quite widely in my work and studies about eating disorders but have not come across very much on this topic, beyond the fact that the two diagnoses can occur together.  It strikes me that the interaction between eating disorder support services and other support services like personality disorder teams or wider community mental health teams, is something that warrants much exploration if we are to support someone not only to recover physically from an eating disorder, but emotionally as well.

*When I was in the midst of the eating disorder it frequently did feel fantastic.  I am NOT advocating eating disorders and I know rationally now – thankfully – that it was anything but fantastic when I was anorexic.  I am thankful to be recovered and for the work of specialist eating disorder counsellors and services, GPs and CPNs who so dedicatedly help sufferers.  I urge anyone struggling with food and eating to get help.

At the same time, I am acknowledging that disordered eating does serve a purpose and function.  It is a way of coping.  It is harmful, as overdosing, cutting, other forms of self-harm are harmful and risky, but it is a way of coping, just as I believe other forms of self-harm are.  I think eating disorders are a way of coping with so much more than the thought processes I have outlined here.  It is different for everyone.

I believe – and I think the clinic the two friends I mentioned work in takes this seriously – that for it to be possible to survive recovery from an eating disorder and take the next steps, treatment has to respect that eating disorders are a coping mechanism, and then enable the sufferer to find alternative coping mechanisms, for example in this case, other ways to deal with the terrifying emotions and extreme lows and highs.

Though I never was specifically in treatment for my eating disorders, I am now very very fortunate that the service treating me now is helping me find these other ways of coping, and I think that as this is the start of dealing with so many aspects of my personality disorder, it will also restore my relationship with my physical body and its need for nourishment.

Ginny x