Musing on this question will take more than one blog post, so consider this a beginning.

Glenn R. Schiraldi, Ph.D. concisely describes this concept in The Self-Esteem Workbook and when I first encountered it, to be perfectly honest with you, I was stunned.

A new concept…

I’d never considered it before. Perhaps it’s a new concept for you, too.

So I thought I’d share some of Schiraldi’s wisdom, research and insights with you today because just reading about unconditional worth made me feel better about myself.

Maybe his knowledge will be a tonic for you, too…

Here’s how Dr. Schiraldi begins Chapter 4 on The Basics of Human Worth:

Unconditional human worth means that you are important and valuable as a person because your essential, core self is unique, precious, of infinite, eternal, unchanging value, and good. Unconditional human worth implies that you are as precious as any other person.

Howard’s Laws of Human Worth…

Schiraldi defines unconditional worth using five axioms based on the work of psychiatrist Claudia A. Howard (1992):

1. All have infinite, internal, eternal, and unconditional worth as persons.
2. All have equal worth as people. Worth is not comparative or competitive. Although you might be better at sports, academics, or business, and I might be better in social skills, we both have equal worth as human beings.
3. Externals neither add to nor diminish worth. Externals include things like money, looks, performance, and achievements. These only increase one’s market or social worth. Worth as a person, however, is infinite and unchanging.
4. Worth is stable and never in jeopardy (even if someone rejects you.)
5. Worth doesn’t have to be earned or proved. It already exists. Just recognize, accept and appreciate it.

These qualities pertain, according to Schiraldi, to the core self, like a newborn child who is “right and whole–complete but not completed.”

Completed means fully developed and finished, Schiraldi writes. A person is complete in the sense that each has every attribute, in embryo, that everyone else has–every attribute that is needed. The core is beautiful, loveable, and full of potential.

Environment (and genetics, I suspect) can muddy this picture…

Unfortunately, even if our core selves are complete and whole at birth, or in utero, innocent and filled with all the potential in the world, environment, the externals, can create problems. Plus, genetics can also play a role in hurting the core self.

I am reminded of a book I read years ago by humanistic psychologist Carl R. Rogers called On Becoming A Person ~ subtitled A Therapist’s View of Psychotherapy. This book is a classic. It may be considered outdated. I don’t know. But I think it should be, if it isn’t, required reading for every psychologist, social worker and psychotherapist, today. I cherish my yellowed copy enormously.

Here’s why. In today’s neuroscientific world, the core essence of a person seems to be supplanted by DSM disorders and syndromes and illnesses of the mind. And as real as they may be, they seem to erase all our innate uniquenesses. Our individual humanity. Our “me-ness” ~ which can be pathologized.

Here’s how Saul McLeod of Simply Psychology summarizes the work of Carl R. Rogers:

For a person to “grow,” they need an environment that provides them with genuineness (openness and self-disclosure), acceptance (being seen with unconditional positive regard), and empathy (being listened to and understood).

Without these, relationships and healthy personalities will not develop as they should, much like a tree will not grow without sunlight and water.

Rogers believed that every person can achieve their goals, wishes and desires in life. When, or rather if they did so, self actualization took place.  This was one of Carl Rogers most important contributions to psychology and for a person to reach their potential a number of factors must be satisfied.

Here’s a diagram of the factors needed for self actualization as designed by psychologist Abraham Maslow, a contemporary of Rogers:

• physiological needs ~ air, food, water, shelter, sleep, sex
• safety and security
• love and belongingness
• self-esteem
• Self-Actualization: vitality, creativity, self-sufficiency, authenticity, playfulness, meaningfulness

Once I asked my psychiatrist, Dr. Bob, if he felt as a child “good enough,” if all his “needs ” were met. We had been discussing an earlier psychologist and his theories of early childhood development ~ Jean Piaget. (Actually, I think feeling “good enough” is a popular way of being “self-actualized,” but I may be mixing up my psychologists, here.)

Dr. Bob  said, “No, I don’t think I did. Not as a young child.”

“How did you achieve a sense of feeling ‘good enough,’ then?” I asked.

“I had to learn on my own, when I was older. And it’s probably a life-long process,” he said.

I’m going to stop here. This post is long enough.

Feeling Better About Myself ~ A Priority, Starting Now…

I’m going to finish reading Schiraldi’s chapter, about “Separating Worth from Externals.” No easy feat in our contemporary culture. About “Why Individuals Have Worth.” And “Reflections on Unconditional and Equal Human Worth.” I’m going to reread the first chapter of Rogers’ book, titled “This is Me,” and I’m going to start feeling better about myself.

I’m going to make that a priority.

Starting now!

Hugs,

sln

Baby Image via doctordisruption

So, naturally, I’m attempting to follow the meal plan designed for me in my Eating Disorders Program right down to every teaspoon, gram, ounce and millilitre.

I am trying to eyeball my portions, but my eyeballs are slow learners.

Plus the stresses of my life make this precarious…

I keep forgetting that I don’t have to be perfect. No one expects perfection.

I miss the support and camaraderie of the other patients in my group plus the expertise and advice from all the psychiatric, psychological, nutritional and social work staff who were always there for us, watching us, keeping us on track and caring about us.

Now, I’m doing everything by myself…

All my meals were supplied for me, with the exception of my breakfast.

By myself, alone, it’s a huge challenge to stick to this meal plan, which involves eating a wide variety of foods (anything, including my forbidden foods) at five specific times and in specific quantities.

In the program, I barely had to think.

Now, I’m meal planning and portioning all by myself.

There are some serious pitfalls…

I tend to restrict and underestimate portions. Then overcompensate. I eat too much. Sometimes I miss a meal or snack. I fool around with the meal plan but invariably, this leads to mini-binges. Guilt. Triggering emotions.

Plus, now, every day, I’m walking my dogs individually, which means a minimum of 50 to 60 minutes of brisk winter walking. While I was in the Eating Disorder program, this activity was forbidden. Almost every activity was forbidden ~ exercise of any kind ~ including using stairs.

Adding exercise changes the meal plan…

You can add a choice or two, depending on how much activity you do each day.

Now, I stair climb when I’m travelling around the city and up and down the 28 stairs of our townhouse ~ normal stair climbing ~ instead of taking elevators and escalators, which I hate. (No, I don’t run up 10 flights of stairs, though occasionally I have the urge.)

I’ve not yet returned to the gym and when I do, it probably won’t be more than a weekly visit. Other less triggering exercises will take its place. Like Pilates. Or swimming.

My body is in transition right now…

This morning, Kim Watson, the wondrous psychologist with whom I now meet every Monday at noon, spent some time reviewing the meal plan. She stressed that I have to trust the meal plan. And stick to it religiously.

She reiterated something I had heard many times before, in program ~ that it takes your body a minimum of a year, perhaps two years, to find its comfortable weight. To reestablish its set point. For your metabolism to settle down. To find its norm, after a lifetime of damaging yo-yo dieting or restricting, starving, bingeing, purging.

You have to trust the meal plan…

I’m anxious. In March, I’m going to visit my mother in Florida ~ a triggering place ~ and some of my summer clothes are tight. I’ve gained weight, though I have no idea how much. I don’t ever want to know that number.

I’m working hard to accept that the body I have now is a good body for me. Trying to learn not to want it to be smaller or thinner is a huge, almost insurmountable challenge. To fight the media imagery. The old records. Our culture.

You should hear the fighting words in my head every time I glance at myself in the mirror.

Body acceptance is a major paradigm shift for me…

My body is learning to live with a sufficient number of calories (about 1,800 ~ though I do not count calories, rather I count choices) which is the right nutrition for my height and age as computed by the doctors and dieticians at the Eating Disorders Program. If the calories I eat vary from day to day, that’s fine. I’m learning to live with the concept of ranges.

That’s a norm.

Though most people believe that maintaining weight is a hard science ~ calories in, calories out ~ it is not. Remember, your body needs a minimum of 1,400 calories a day to function, to breathe, to run your cardiac system, your organs, to pump the blood through your veins. Even to sleep. That’s what your body needs to survive.

What you should weigh is genetically predetermined, unless you start restricting, which automatically leads to bingeing. Then your metabolism gets skewed, corrupted, goes out of sync.

That’s why dieting is potentially so dangerous…

In the big picture ~ and we’re all anatomically complicated big pictures ~ we all live within ranges. Nobody is rigid. Our bodies are ingeniously engineered mechanisms (Weightless) that are in constant flux. Body weight normally varies about five or six lbs. over a week and in some cases, as much as 10 lbs. over a month.

The most promising thing I keep telling myself is that for the first time in my life, I’m not abusing my body by dieting. I’m not starving it. I’m treating it with the respect it deserves. I’m feeding it. I’m giving it the food, the medicine it needs to function. Food is medicine for the body.

Appreciating my body…

Part of my therapy is appreciating my body. (Once again, thank you Margarita Tartakovsky for this reaffirming and wonderfully helpful Weightless post.) In appreciating my body focus on all the things my body does and can do for me and for others. I do not focus on my appearance.

I’m working diligently on self-esteem. I keep copious notes that reinforce what I like about my body, positive points that do not involve appearance. All my life, I’ve detested my body, so this is a brand new experience.

For example, I like my smile. I love the bonding feeling I have when I’m cuddling with one of my dogs. And the utterly unconditional love and affection that my husband Marty gives me, non-verbally. Just by touching me. I love his touch.

I like my energy and my youthful approach to life. The spring in my step. My optimism.

These are some of the things I like about my body and what it does for me. I keep a chart and write down three of these things every day.

Relapse within the first year of treatment is highest…

This is so incredibly hard. You have no idea.

But I know I must do it to survive.

Within the first year of treatment in an eating disorders program the relapse rate is very high. The highest. And yes, people relapse. Lots of people relapse.

I refuse to be one of them.

Image via Pinterest

Not here, I’m afraid…

Though I’d love to be here with you, instead, I’m writing reams about body image ~ mine.

It’s exhausting and triggering. Working on recovering from my eating disorder with psychologist, Kim Watson, Ph.D involves reading two workbooks ~ on body image and self-esteem.

Every day, for at least one hour ~ usually more ~ I do challenging writing exercises that resonate in places I don’t really like going.

I spent last week in the past…

For me and my body, the past not a pretty place.

These exercises forced me to remember and envision what my body looked like to me and felt like from age zero right up to now.

I catalogued “influential experiences and events” that have fed my negative body image for as long as I can remember. If your body image is the embodiment of yourself, a symbol of who you are, mine’s damaging. I’ve always had a turbulent, love-hate relationship with my body. More hate than love, I’m afraid.

I don’t like my body. Never have. Ever…

It’s probably not a great idea to even write this, but it’s the truth. Even when I was a little girl. I never felt good about my body or in my body. Now, I’m facing all that, head on.

Curiously, when I confide to people that I’m working with a psychologist on improving my body image, invariably they say, “Your body image looks fine to me.”

That’s not the point.

It’s what my body image looks and feels like to me, inside, in my mind. That’s what counts and right now, I’m rather fragile.

The Empty Chair Technique…

This week, the second of my sessions with Kim, I sat facing a chair that appeared to be empty. But actually, it wasn’t. It was inhabited by my body.

During our first session, I had mentioned to Kim that all my life, I’ve not only hated my body, I’ve abused it. Starved it. Stuffed it. Exercised it beyond exhaustion. Injured it. Belittled it. Despised it. Criticized it. Treated it with contempt.

So this week, while getting dressed to go and see her for my second session, it occurred to me that I owe my body an apology for all this abuse and disrespect. After all, I’m here. I’m healthy, considering I had a kidney transplant almost 18 years ago. There’s really nothing my body won’t do for me, physically.

Even my broken arm is healing quite well. It’s not a bad little body when you consider all that.

So, this week, she asked me to apologize to my body.

Conversing with my body was cathartic…

This Gestalt ”empty chair technique” proved to be quite emotionally enlightening.

I don’t remember how this “conversation” between me and my body went. Kim prompted me with questions. But when it was over, she remarked that at one point I became “teary-eyed.” I didn’t realize it at the time.

There’s a lot of pain wrapped up in all this, pain I’ve been avoiding. Now, we’re beginning to tap into it.

All this is tremendously triggering…

All these memories were deeply disturbing and for the first time since beginning treatment, I binged a bit.

So, we decided to get away from this body image work, to change course this week.

Kim suggested that during our next session, we review the eating plan and focus on The Self-Esteem Workbook by Glenn R. Schiraldi, Ph.D. It would keeping me in the present and I would be acknowledging positive qualities, experiencing pleasure and unconditional love.

Sounded good, until this morning, when I woke up and went down to my office.

What a mess…

Lo and behold, overnight or after Marty left to teach this morning, a big floor-to-ceiling bookshelf containing dozens of files and other office stuff, had pulled away from the wall. All my boxes of files and papers were heaped haphazardly on the floor and shelf unit was listing precariously at a 90 degree angle.

Luckily, no one was hurt, namely my dogs, but I spent the morning removing everything from the shelf to prevent it from falling over. I called a shelf-specialist who came over to help me find a reasonably inexpensive and safe solution.

What fun! Needless to say, experiencing pleasure wasn’t in the cards for me this morning.

It could have been worse…

On Monday, Kim mentioned that she had spoken at length with my psychiatrist Dr. Bob, who had stressed that I was quite resilient. (Click on this link for more insights on how to “bounce back and develop your resiliency” by new Psych Central blogger, Los Altos therapist, speaker and author Bobbi Emel.)

“We really don’t know why, but it’s quite remarkable,” she said.

Remarkable? I don’t think so. I think it’s because I’ve had so much practice.

Now, onwards and upwards.

Image via Pinterest

I had a fresh, liberating understanding of what “normal” eating is for me. For everyone. We need a minimum number of calories for our bodies simply to function.

That number is always ignored by the diet industry. Though I no longer count calories or weigh food or even weigh myself, I know that my body needs 1,400 just to exist.

Because of my broken arm, I’m not doing any exercising. Not yet.

Risking a fall isn’t an option right now…

Furthermore, exercise is an activity I must work back into in a safe way, since I have used exercise as a form of purging. That kind of thinking, exercise in order to control weight or change body shape is no longer an option for me. It’s not healthy or realistic. It’s a specious way to try to control your weight. You can’t. Your genetics determine your optimal body weight. That’s a whole other story.

A meal plan, journaling and recovery are my goals right now…

I follow a meal plan, which is simply a guide specifying the number of choices that will appropriately fuel my body at my age ~ 63 ~ and height ~ 4-feet and 11 inches. (I believe I’ve shrunk!)

Keeping a daily eating behaviour journal is now second nature for me. As my hand and arm heal, I’ll begin to fill in some of the feelings associated with my choices.

It’s a vital part of my recovery…

I have millions of choices ~ anything I want ~ and I’m enjoying exploring and savouring foods, often new foods, and eating more than ever before. Guilt-free. Like most people.

We need food. When I’m not hungry, but mealtime comes, I use a variety of coping strategies. “Food is Medicine for your body” works really well for me, because my old norm was to restrict. To starve. Then binge. It was a vicious cycle.

Now, I’m able to stop that cycle… 

I am beginning to understand and recognize feelings of hunger. I eat five times each day. Three meals and two snacks, including a mid-afternoon and evening snack.

It’s great…

However, that’s only my eating. A beginning.

I am still struggling with body image issues, so tomorrow at 12 noon, I’ll begin working with a registered psychologist on this vital phase of my recovery. I’m still seeing my psychiatrist, Dr. Bob, but he is not professionally equipped nor is he interested in dealing with body image.

My new psychologist, who specializes in Body Image, Self-Esteem and other adult and rehabilitation issues, will pick up the ball. She recommended I buy The Body Image Workbook, An Eight-Step Program for Learning to Like Your Looks by Thomas F. Cash, Ph.D. I did and this morning, I’m doing a series of self-tests to determine the extent and unique “look” of my particular body image issues. They date back years, by the way. I cannot ever remember liking my body or being comfortable with the way I look.

Self-consciousness is my alter ego…

I have completed this profile and will find out how to interpret them tomorrow.

In the meantime, I religiously follow Psych Central Associate Editor Margarita Tartakovsky‘s insightful and enlightening Weightless blog and her frequent World of Psychology posts. Margarita has helped me enormously in my recovery and I’m overwhelmingly grateful to her.

I urge you to read her blog if you harbour any body image issues ~ and in our youth and thin-obsessed culture where glamour rules ~ it’s hard not to feel overly self-critical and unhappy with our looks. We forget to look inside, where all the good stuff is.

Here, in the near future, I hope to broach other issues relating to mental and emotional health of all kinds.

Now then, enjoy the rest of your weekend and if you’re in my neck of the woods, stay warm!

Image by Pinterest

Happy 2012. I have resolved not to make any resolutions, other than to be more empathetic with Marty, my husband, who has a completely different temperament than I do.

My mind works faster than my left forefinger, so writing this blog is not easy for me. Living with me is not easy either, but we’re doing much better. Couples therapy is wondrous if you find the right therapist and, happily, we did through my eating disorders program.

Today’s big news? 

My cast comes off today ~ I hope.

In the meantime, to make life easier for Saint Marty, I had all my hair cut off. Every little bit helps. I love it and when both my hands are working, I’ll send you a picture.

Since we last spoke, I was on Day 31 of my Eating Disorder Treatment Program.

Body Image Therapy, now…

I have now finished, as of last Friday, January 6th and now I move to step two ~ work with a psychologist who specializes in Body Image Therapy. Dr. Bob doesn’t do that kind of work.

That begins tomorrow.

Today, at 1:30 p.m., we meet with Dr. Rumble to assess my right arm. The good news is that I am doing a great deal more with it than last time, including dressing myself, though I still cannot lace up and tie my shoes and boots. I have grown quite adept at screwing and unscrewing bottles and flipping off the tops of my pill bottles.

Lots of other things, too.

Something happened…

But I want to tell you about something that happened. You should know. Doctors and other health professionals are human and make mistakes.

The day after I broke my arm ~ Wednesday, December 14 ~ I became manic. I didn’t sleep at all that night. Very serious for me.

Sleeplessness is deadly for my hypomanic mind…

I suspect when I broke my arm ~ I heard it crack ~ something cracked in my mind. I became delusional. Funny and delusional.

Then, what happened next was a confluence of bad luck and human error. We’re all human. Doctors, psychiatrists, social workers, psychologists.

Dr. Bob was out of town. Just my luck. My mood disorder is so rare, he never leaves a back-up and in 20 years, this has never happened. I never needed a back-up. Anyway, since Marty has never seen me manic, he didn’t know. Neither did I. Anosognosia was at work.

Deep denial. My reality was fine. Everyone else was crazy.

Long story short…

I decided to take public transit downtown on Thursday, December 15, after a painful and sleepless night. I was delusional. I thought I saw Ryan Gosling and George Clooney running the subway. In my mind, I was thoroughly convinced.

The gang at the ED program were somewhat alarmed, and worried. They didn’t know what to do with me, so they shipped me off to another hospital with a special psychiatric ER. I had an escort but no note or paper work on the shuttle that took me there.

When the triage nurse finally called my name, I asked her, “Why am I here”?

“Aren’t you applying for a job,” she said.

“No, I think I need to see a psychiatrist.”

“Okay,” she said.

And I was instantly escorted into the Psychiatric Emergency Waiting Room. My bag, all my personal belongings, even my cellphone, were all locked up. This was all too familiar. I’ve been through this too many times before. And all I wanted to do was sleep. But there were no beds. So I sat.

And sat. And sat. And sat. For hours…

Finally, I started screaming and a nurse spoke with me, asked me some questions, the usual stuff. Then he let me sleep. When I awoke an hour or two later, I knew I wanted to go home.

Why was I there?

I was in pain. My arm had long ago slipped out of my sling. I had had no pain medication. No anti-anxiety medication, the stuff I always carry with me. It was all locked up.

“I want to go home,” I yelled.

At last a psychiatrist came to see me.

“If you keep screaming, I’ll cite you for aggression,” he said gently.

I instantly calmed down.

We had a nice chat. He was a very kind man. I told him I wanted to go home. To my husband.

“So call him,” he said. “You’re free to go home.”

“They locked up my phone.”

He said, “There’s a phone right over there.” I called our number.

Marty had no idea what had happened to me…

He was hysterical. He hadn’t heard from me since 8 a.m, that morning and it was now 8 p.m.

No one had called him.

I arranged to take a cab to our regular hospital. He was familiar with it. I had no idea where I was in this other hospital.

Just before I left, they gave me back my coat, backpack, everything they had locked up.

They also gave me a pink Emergency Report which stated quite clearly in print, taken from the information on my Ontario Health Insurance Plan card:

“In case of emergency call Martin Lager, husband.”

No one had ever thought to ask me that day, if I had a next of kin. The most obvious, rudimentary question. Everyone knew I was married. They had met Marty through the couples therapy offered at the Eating Disorder Program at the other hospital.

But that slipped everyone’s mind, including the psychiatrist who heads the program and every single member of the ED staff.

I slipped through the cracks…

I am not typical. So they panicked and forgot to ask me the most obvious question.

On Friday morning, my psychotherapist, who had masterminded this plan to send me to that other hospital, called to apologize for the mistake. Friday night, Dr. Bob, who knew nothing about it until he returned that day, called.

“I understand you’ve been through a traumatic experience,” he said.

During our next appointment, the next week, I showed him the pink discharge report.

Mistakes can be great teachers, if you’re open to learning…

We discussed the potential empowerment of mistake-making. How you can learn from mistakes. Maybe the Eating Disorders Program will learn that people, all kinds of different people, including people with rare mood disorders, can develop eating disorders.

Maybe they’ll learn something from this mistake.

Or maybe not.

I don’t have to go there anymore.

Read the comments to that last post. You’ll see some of my progress.

Since then a few things happened…

I snapped the picture you see, this morning. It’s a tight shot of my right hand.

Note the discolouration on my thumb. Not dirt. It’s a bruise, black and blue.

Also…

I am very right-handed and not, as I have discovered ~ in the least, whatsoever, in any remote way ~ ambidextrous. The plaster cast you see goes up to my elbow. It weighs “a ton.” Feels like it, anyway.

After a stupid fall on Wednesday, December 14 ~ all falls methinks are stupid, right? ~ and an x-ray revealed that I had indeed broken my right arm above my wrist, the technician in the ER fracture clinic said I would be able to have a yellow fibreglass cast in a week. Mmmmmm. My favourite colour.

So such luck for me…

The following Monday, back at the hospital’s orthopaedics and plastics centre, I saw my x-ray.

The orthopaedic specialist looked like he was right out of Central Casting. Tall, silver-haired, elegant in his crisp white lab coat, kind, gentle and twinkly-eyed behind his wire-rimmed spectacles. I felt I was in good hands. Safe. Especially with my husband Marty beside me.

“If you’re going to break your arm,” Dr. R. said, “That’s the way to do it.” He cleverly rotated the x-ray, showing a jagged line going almost all the way through my arm, about two inches south of my wrist. On the same hand I broke several years ago.”You see, no fragments. Nice and clean.”

Dr. R. then gave me the bad news. “No fibreglass cast for you. And you would be better off without that sling. (I was given a sling in the ER.) The more you exercise your fingers, the less physiotherapy you’ll need.”

My cast comes off on January 9, 2012.

So, that’s surprise number one…

I am now typing with my left hand only. My mouse is on the left of my wireless Apple keyboard. My right hand is resting on a pillow where my mouse used to be. Everything seems to work upside down. It is slow going.

Saint Marty…

I often wonder if my husband of 11 and 1/2 years would have so blissfully uttered “I Do” on August 22, 2000, if he knew then what he knows now about how challenging life with me really is. I’m no picnic, though he swears he’s never bored.

Still. Had he any premonition, I suspect he may have opted for, “I Do Not!”

Since this last mishap, for two weeks, Marty helps me to open numerous pill bottles, unscrew anything that needs screwing, including toothpaste. For the first few days, he had to screw in my right hearing aid, until I learned to do it myself. He cuts my daily luncheon sandwich, butters my bread, sponge bathes me, cuts my food, helps dress me, ties my shoes, makes the bed and assists me in the loo. That just scratches the surface.

My right hand is painful and powerless…

Marty walks our two dogs four times a day, drives me to all my appointments and does all the chores. Plus, in our double bed I keep him up half the night thrashing around with my rock-hard plaster arm. So he’s perpetually sleep-deprived.

He never complains. He’s 75 and I’m afraid I’m aging him fast. His 24-year-old daughter told him last week that he was looking older, and no wonder.

This weighs very heavily on me.

As for my eating disorders program? I’m still there…

And one major requirement is keeping a daily eating journal.

Here’s what mine looks like for today:

A pre-schooler’s scrawl?

Nope, mine with my left hand. Cute, isn’t it?

Looks more like the pedestrian scribblings of a three-year-old pre-schooler than a 63-year-old journalist with 40-years of professional by-lines beneath her belt.

And something else unexpected happened, surprise number two…

After two weeks of trudging downtown, a 90-minute commute by car and the subway and on foot each way, it was abundantly clear that I was not a good fit for this well-regarded, awardwinning Eating Disorders Day Program.

I have always been a square peg unable to find a square hole into which I can fit. This program, like public and high school, was no different.

That’s an old story.

The point is, I am just too, too different…

And so it was at my beloved ED program, where, by the way, I was excelling.

Clearly, the other patients in my group were uneasy. I was constantly being disciplined, given ultimatums, encouraged to muzzle myself by various staff. They did their best to be kind, but I began to feel like a pressure cooker about to blow my top. Swallowing my energy. It was killing me, though I refused to give in.

The team often softened their blows by stressing that there was nothing wrong with me, but I felt like a naughty child, unable to be me.

I wanted drop out, several times…  

Dr. Bob just kept counselling me to “tough it out,” “play the conformity game,” and “stick to the meal plan.” Three meals a day plus two snacks. This, I did, religiously, as perfectly as I could.

His parting shot was, “you’ll be fine,” and then he had to go out of town all last week and I was high flying, without my net.

That, however, simply wasn’t good enough…

You see, instead of being withdrawn, introverted, depressed, deeply ashamed or self-blaming, between 17 and 35 years of age, though there are others, men and women outside that age demographic, clearly I was larger than life, out-there, “with no secrets and no lies,” a big, strong personality, exuberant, brimming with energy and overwhelmingly high octane. (Though a lot of that is my way of coping with the profound sadnesses I have been dealt.) Few ever figure it out. I am a very good actress. And not the classic profile of patients with eating disorders.

Still, I was very very sick, nonetheless. Starving myself.

Chronically restricting had always been my norm. I never dreamed it was in any way abnormal.

Here’s the good news…

Instead of bouncing me out and onto the street from Group 2, the small group program I was in, the wise ED team offered me a third, rather rare option.

Group 3 ~ a one-on-one approach.

You miss the Education group, the Cognitive Behavioural Therapy group, the Managing Your Emotions group and the dazzling bi-weekly Spirituality group. You miss schmoozing with the brave and dauntingly courageous patients all of whom had quickly become like family to me.

We sat down together and “broke bread” together like a family.

Four times a day, we shared meals, chatted about light stuff ~ books, movies, gossip, Christmas shopping ~ anything but food, eating or body-image. We snacked with each other. We went on short walks together. The whole group, large and small.

And now…

You miss the camaraderie and collegiality with patients who share your obsessions and phobias and fears about food and eating and distorted body images, who have their own rituals which we discussed in the safety of our cloister. We were all working ourselves to the bone to normalize.

It’s the hardest work I have ever in my life done, and now, I am doing it by myself, with longer, more frequent and intense, one-on-one psychotherapy and family counselling sessions.

I think it is going to be fine…

And, hey, I’m already beginning to feel so much happier with my body and with whom I am. “Me.”

Still, there’s one more surprise and I’ll tell you about that next time. My left hand is aching and it’s time to begin thinking about dinner. It’s 7:00 p.m.

Sending hugs and hope that you enjoyed Christmas, Hanukkah or any and all your holidays, thus far.

Photo Credit ~ Sandy Naiman with her iPhone 4S on Tuesday, December 27, 2011 at 1:30 p.m. EDST 

It’s Day Three of my five-week Eating Disorders Day Treatment Program.
My goal for tonight was to write to you, to let you know what’s happening.

To be honest, mealtimes are hard for me. Right now, I feel nauseated. This happens after every meal there, and not because it’s hospital food. After breakfast, here at home, today. I became nauseous.

Is this normal?

Yes. Apparently, for someone with an eating disorder at the beginning of treatment, nausea after eating is normal.

Tomorrow, I will be meeting with a psychiatrist who may, perhaps, prescribe something to help me digest more easily. Motilium, I don’t know. Taking another prescription drug, in addition to the complex cocktail of drugs for my kidney transplant and mood disorder doesn’t thrill me. But, we’ll see.

A Ph.D in “normal” eating…

What I will share with you is that I’m learning so much. I feel I’m in graduate school.

I never knew what “normal” eating was because I’ve restricted food, feared food, abused food, binged on food and misunderstood food, all my life. In fact, it’s medicine for my body. Like insulin, if I had diabetes. And now, I’m learning all about about it. I realize I know nothing. Just myths. So many myths. Astonishing.

The time zooms by. Each day, in a series of educational groups, classes, meetings and activities, we learn, discuss, share.

There is our daily Community Meeting, then Cognitive Behaviour Therapy, Emotional Relationships Group, Spiritual Group, Nutrition and Menu Planning, Weekend Planning, short walks, check-ins, weigh-ins, cooking and shopping. I don’t even know the whole weekly cycle will be.

My therapist is the essence of calm…

Three times a week, I meet with my therapist, one-on-one. Not Dr. Bob, but a social worker. I simply adore her. She is the essence of calm – and smart. In no time, she twigged to my innate intensity, obsessiveness and anxiety.

We have “independent work” times, too. Time to read and do our homework. There’s tons. And talk. Curiously, there are little tins of Play-Doh in our lounge. A variety of books. A big tin of wooden building blocks called Jenga. I’m looking forward to trying it. And to toying with the Play-Doh, too. Reminds me of my childhood. Perhaps that’s the point.

There are so many “norms” to learn…

You wouldn’t believe how anxious I am. I have a genius for mistake-making and in the last three days, I’ve excelled. There are so many “norms” to which I must adhere and the only way I seem to learn them is to “break” them.

At lunch, I had a cookie, today. One, rather large cookie. As is my wont, I broke it up in little pieces as I was eating it and one of the two dieticians who watch us eat very closely stopped me and told me I must take bites out of the cookie. Not to break it up.

“Why?” I asked.

“It’s one of our norms,” she said.

That was that. We’re not allowed to discuss food or body shape during meals or community meetings. We must keep things light. Movies. TV. The weather. Books.

Next week, I may be able to go shopping. I may be able to cook there. I don’t know. All this is so new to me.

As for the actual eating, it feels like I’m eating huge amounts, when in fact, I’m told, our menus feature “normal” portions! We are learning to “normalize” our eating so that at the end of my five weeks there, I will begin to feel better about eating and will have the tools and strategies to help me continue to eat normally. Three meals a day plus two snacks. At specific times. “Mechanically.”

You cannot control your weight…

It will take at least a year to accomplish all my goals, but the main one is to let go of the idea that I can control my weight. Then, to be more self-accepting. Less self-conscious. Less perfectionistic.

Meanwhile, I’m going to take up knitting. Everyone knits. It’s a great way to occupy your hands. Distract yourself. One of our “behavioural strategies for eating disorder symptoms.” I cannot chew gum or suck on candy. Cannot drink between meals. Nor can I use any diet products. At all. Ever.

So this is the beginning of a new way of living. A new way of eating. A new life.

One of my goals is to blog each week. And the other is to keep a journal. I’ve started the journal. It’s handwritten. I want the feeling of writing, again. It’s different than typing. More intimate.

See you next week.

Image Credit: Pinterest

Kids with mental illnesses and visual impairments…

She and a group of teachers, parents and professionals working with blind or visually-impaired kids had asked me to speak at an annual conference ~ about mental health

A New Challenge…

Admittedly, I have never spoken or facilitated any kind of workshop on the subject of mental and emotional health for children and youth who are visually-impaired, had never even thought about this particular demographic

The topic fascinated me, so I was anxious to continue our dialogue.

With my hearing loss, it seems I’m one “advocate” with a bit of an edge. Empathy for how isolating sensory deprivation can be ~ any sense. Hearing loss is invisible, aligning it, curiously, to a mental illness.

Blindness, however, was utterly new to me…

Quite understandably, children and young people with blindness or visual losses have a score of extra emotional health problems, not the least of which is depression, feelings of isolation and marginalization. Imagine, in this world of touch screens, iTunes, iPods, iPads ~ this utterly and completely visual world ~ not being able to play.

Then, layer on a mental illness.

Imagine how excruciatingly hard it must be for kids to accept a mental illness or a psychiatric diagnosis on top of being blind or visually impaired. How do they cope? How do their families cope? In many cases, they don’t.

Most of these children and teens are integrated into the public school system, “though that’s changing,” this woman told me. Often, a visually impaired child may be the only one in his or her school. It’s seems so inhumane.

Bullying is a serious problem…

Social integration can be close to impossible for these kids, which is why their families are increasingly moving them to schools for the blind where they can relax and use all the aids available to them.

“In these schools, they can flourish. In an integrated situation, they tend to feel so ‘different’ that they will refuse to use their white canes in order to attempt to fit in and in doing so can handicap themselves even more,” the CNIB service manager told me.

Some of these young people experience depression so severe they contemplate suicide.

Several years ago, a young visually impaired teenager died by suicide. This teenager was using the services of the CNIB, but somehow, he was beyond reach and fell between the cracks. There was no one there who could help him or understand him.

A suicide in a young blind teenager prompted this conference…

Sending one of our children in emotional distress to an ER often proves futile because the information their psychiatrists and psychologists have rarely gets to us, said this service manager. It’s a strange situation.

This suicide prompted the idea of a special conference to address the complex issues of “Mental Health and Young People with Visual Impairments,” a workshop she wants very much to coordinate.

I suggested something interactive, with participants using blindfolds for group activities. Lots of teamwork and cross pollination. Sharing of experiences and ideas, especially as some of the teachers have visual losses. Perhaps several of the young people at the CNIB might be willing to come in for  an impromptu panel, I suggested. Very informal and somewhat staged. I would meet them ahead of time, to help them relax. Get to know them.

A safe, open forum where everyone can express their feelings…

“Don’t you think it’s important to hear how these kids speak up about how they’re feeling? Their emotions? If we could create some cross-pollination, I think that might be helpful. For everyone. Think of how this kind of open dialogue might help everyone develop resilience. And deal with the stress.”

As far as I can see, the real insights will not come from me, but from the kids and their parents and teachers. The meeting of minds. Hearing how they feel and knowing they’re not alone.

They need a chance to speak up, speak out and listen to each other and be heard in a safe and non-threatening environment. To know they’re not alone.

If you have any insights, thoughts, ideas, would you share them with us? I would be eternally grateful for your help. Any help.

So would these kids.

Thanks.

This conversation will be continued. I’ll keep you posted.

Photo Credit: Mega Mack at Pinterest

During that time, I was extremely ill. At one point, I became catatonic.

Following that hospitalization, I recovered at home with the help of my mother, who made two wise decisions.

My mother and my recovery…

The first, was to buy a dog for me to care for.

I was the sole family member to help her.

Finally, we settled on a Yorkshire Terrier. After accompanying my mother to dog shows and various breeders, we found our little pet. In this case a two-year-old retired show dog we named Derrier, or Derry for short.

Learning calligraphy was another recovery technique…

My mother was involved in a charity. Learning calligraphy was one of her chapter’s pet projects (no pun intended) so personalized plaques could be given to honour worthy recipients. These plaques were a form of fundraising.

I found calligraphy strangely therapeutic.

I loved learning calligraphy…

By no means gifted ~ my kid sister would go on to show much more promise and a career in invitation design ~ I found the quiet, intense concentration demanded of learning to wield a stick-nib pen with black ink tremendously calming. In short order, I was proficient enough to be able to fill in the little scrolls that were given out.

Already passionate about words, I fell in love with typography and fonts. This love affair persists, as anyone who receives email from me with attest. I change fonts often. Right now, I’m using Optima, which was designed by German typographer Hermann Zapf.

Me and Steve…

Thus, I found reading Walter Isaacson’s biography, Steve Jobs’ fascination with calligraphy was one of the few areas we had in common ~ besides our passion for all things Apple. Certainly, technology is not my strong suit. Nor is salesmanship.

Last week, a PBS biography ~ Steve Jobs – One last Thing ~ focused on his fascination with typefaces and the Trappist monk, Robert Palladino, who taught him at Reed College. Calligraphy fired Jobs’ genius for design and his punishing perfectionism.

Yet in Isaacson’s biography, one of his ex-girlfriends suggested that Jobs was a perfect example of Narcissistic Personality Disorder. A friend of mine suggested that he had bipolar disorder.

Why? Just because he was brilliant, a bully and utterly unorthodox. Jobs has been compared to Thomas Edison. Was he easy to live with, I wonder?

Jobs was far from perfect, but who is?

He was seriously flawed, from his eating disorders to his habit of taking credit for other people’s ideas, but even if he did fulfill the requirements of a syndrome in the DSM-IV, so what? Look what he accomplished.

I think it’s intriguing that a psychiatric diagnosis is slapped on Jobs because of his extreme eccentricities. Had he not made billions and changed the way the world communicates, I wonder. Would people, amateurs, be so quick to label him, now that he’s gone?

His devotion to his family and his wife are rarely mentioned in journalistic stories about him. Yet, he was able to reconnect with his sister and heal his relationship with the daughter he fathered and abandoned.

One facet of Jobs’ genius was to “Think Different.”

“Here’s to the crazy ones…”

As far as I’m concerned, it speaks volumes for his sanity, his emotional health ~ his vision. (Watch this 1997 Apple commercial. Listen to the words. It begins, “Here’s to the crazy ones.”) He gave Isaacson carte blanche with this biography. That takes courage, too. All the other salacious and sensational details of Steve Jobs life, the stuff that make good copy, don’t really amount to much, considering the  vast scope of his accomplishments. Even his habit of taking credit for the ideas of others.

Those people who worked with him and for him for years stress they would never have learned as much as they did were it not for Jobs “distorted reality field” and the demands he made of them.

They’re grateful.

So am I.

Image Credit: Pinterest

Today is typical. Though we have had some lovely, sunny, sweet un-November-like days, today is not one of them.

It’s grey and damp and drizzly.

Not a day to lift one’s spirits…

I have often said that I do not suffer with clinical depression. That is not to say, however, that I am immune to situational “sadnesses” or “the blues” or “the blahs” ~ and lately, that is how I’ve been feeling.

There are some solid reasons for this.

One is a feeling of worthlessness. Right now, I am not gainfully employed for the first time in my life. I am awaiting a call from an Eating Disorders Clinic that will tell me I must report the next day. I have no idea when that call will come, thus, it is rather futile to look for any kind of job.

I am not working. I am not writing, as you well know.

My posting here has practically stopped cold.

I am not feeling inspired or inspiring…

Actually, I could work, if I could concentrate. I have an ongoing freelance gig. But I also have a sense of lethargy that makes motivation seem like an Everest I cannot even imagine climbing.

These days, I am not going to my gym and the only exercise I manage is the two or three 40-minute walks I take with my dogs each day.

If you must know, I’m spending far too much time with my Kindle. I’m reading books about people who succumb prematurely to cancer or other illnesses. Steve Jobs.(Here’s an intriguing Jobs story in The Sunday New York Times.) Wendy Wasserstein. Quintana Roo, Joan Didion‘s daughter. Very happy stuff.

Last week, on a rather glorious night, actually, with clear starry skies and bright moonlight, on one of my nocturnal walks, I tripped on one of my dog’s leashes and landed hard on the pavement of a quiet street. It was very late for dog walking. My favourite time, if you must know. About 11:30 p.m.

Bleeding and Bruising…

And there I lay, in pain, in shame, in shock. I broke my fall with my knees and my forehead, which was bleeding.

What hurt most, though, was the fact that my little Dandies stood there, heartlessly. Did they approach me? Did they lick my wounded forehead that was quickly swelling as well as bloodied? Did they give a shit, which they depend upon me to allow them to do and which I was, at that very moment, carrying in little knotted bright blue plastic bags in my fanny-pack?

No. No. No…

That hurt, more than my crumpled and maimed body, lying on the pavement.

My beloved canine wards could not have cared less about me ~ their caregiver, their walker, their groomer. All they wanted were the cookies they were confident of getting and gobbling on our return home. (I do not believe they are dog therapy candidates.)

Anyway, I have decided to try to keep up with my writing. It gives me a feeling of accomplishment. Will these sorry thoughts be of any use to you? I have no idea.

But the act of writing will help me and I’m determined to continue. Once a day. No matter what.

That way, at least, I may not feel as worthless? That’s my plan.

Thanks for listening.