At the end of last year, I had got to the point where I knew I was in deep, and needed help, so I took myself off to see my doctor. I knew very little about treatment options then, and there is still an awful lot I don't know. What I am pretty sure about, is that restrictive eating disorders are very difficult to treat. There is no one solution that will work for everyone (annoying!), and if your health is in immediate danger, you'll be put in hospital with a tube stuck up your nose to feed you. My doctor gave me my bits of paper for a referral to the regional treatment facility with a small giggle and a 'Good luck!'.
The clinic I go to, which specialises in eating disorders, is attached to a local hospital. They offer a full spectrum of outpatient support, bringing in various specialists as you need them. There are psychiatrists, psychotherapists, doctors, dieticians and more. It is very self directed - in other words, it is up to me if and when I want to access the help of any one person. There is no-one enforcing anything there, at least for those who aren't in immediate medical danger. I can shape what my treatment looks like.
Entering the waiting room for the first time, I felt very self-conscious. The walls are decorated with big cheery letters, and board games fill the shelves - all things aimed at making young people feel comfortable. Was I going to be the oldest? The fattest? The most fraudulent? Look at her, I heard them think, in this condition at her age... Did she never want to grow up? Does she want to be a model or something? Because...ummm, it's a bit late. My discomfort didn't last long though - the receptionist was friendly didn't give me a second look. There, I was exactly who they expected to see in exactly the state they are used to people being in. I was normal. I was boring! It was fantastic.
I have been having psychotherapy at the clinic for a few months now. It is unstructured and mostly undirected. It feels like a soft cotton cloud of support, all fluffy and nice. The therapist sits quietly, occasionally making gentle suggestions or acknowledgements, while I do most the talking. Sometimes I feel like I'm just crying 'poor me' over and over for an hour. The style of therapy is deep and open ended. At times, in my quest to get answers, I get just the teensiest bit aggressive. I try and get things moving with some motivational talk: 'Come on people! Chop chop! Let's draw up a fucking chart and put some ticks and crosses on it! Let's nail this sucker!'. But they don't do anything - they just look at me kindly. It makes me want to go stab out my eyeballs with a sharp instrument. At least that'd be action! There'd be blood and gore and movement! Somehow though, psychotherapy is having an effect. I have a much deeper understanding of my eating disorder than I did before I started, and I am not where I was five months ago. When I talk at length and without guidance, I wander into the recesses of my mind and my history. Once the contents are out of my head and in the room, I can stand back and have a hard look at it. Is it a good thing? Does it deserve a spot in my brain, and should I tuck it back in, or should I try and get rid of it?
I haven't taken up some other help they have offered as yet. I don't want antidepressants, nutritional supplement drinks or a meal plan. They don't feel right for me at the moment (especially not the meal plans - I'll be damned if I am going to commit to eating. No way José!), and I need to be in control. So long as I can keep myself healthy enough, they are able to respect my choices.
Alongside the psychotherapy, I have been going to see a psychologist, Penny (not her real name) - a Cognitive Behavioural Therapist. This style of therapy is practical and direct. It grabs your messed up thinking and behaviour by the balls and twists. I had been seeing Penny for a number of years, long before this all happened, so she knows me very well. She was there all last year, as I steadily lost weight, trying to steer me away from this. It was her who prompted me to go and get more help, and her who has kept me out of a hole buried six feet underground. Penny shows me what is already in my heart - that I want to survive and live, and turns my focus to where it needs to be.
Even though I have been having treatment for months now, it was only recently that I discovered some unhappy news about therapy. I found out that it guides you towards change. Deep-seated, excruciatingly difficult change. OUTRAGEOUS. This is not what I'd signed up for! I was very comfortable living in hell, thank you very much! I needed help, sure, but I wanted it to be painless and straightforward. Just some goddam answers that I could slap on, and be on my merry way. I don't want this difficult, murky shit! And I most definitely don't want to start actually eating properly again. Screw this, I thought, I'm outta here.
Except, I didn't get out. I'm still there, and I don't like that change is happening. It's very unpleasant. The ill part of me thinks its just a big conspiracy to make me fat, and there is no way in hell I am falling for it. The healthy part knows that this is for the best, that my children deserve a well mother and that I don't deserve this life either. And despite the uncomfortable nature of the things we deal with, my psychologist makes me feel and be better. I have yet to decide about the psychotherapy - the deep, wallowing, vague stuff. Every time I go, I feel like it might be the last time, but then I think Once more. Because what will happen if I leave? I am still restricting and stuck. What if I go downhill? Will I be able to achieve a full recovery, and be free of this for good, if I don't go in deep and explore all the dark corners of my mind? Or have I done enough to scrape through?