On being sick...and compassionate recovery processes

You know you're in recovery when __(fill in the blank)___

I think that this past week, my version needs to be: you know you're in recovery when...you are as a sick as a dog and your eating disorder does not attempt to get a need met through the process.

A few days this past week, I felt terribly sick. I’ve had a lot of dental work done these past few months. Lately, I have felt a consistent moderate pain, but it’s been well managed. My dentist continued to tell me that we’ll get it figured out; we just want to be prudent. Just one more week. She hasn’t wanted to do a root canal until she’s done multiple bite adjustments. 

I have a story: on Thursday night, I wake at 2am in horrible pain. My tooth and jaw throb intensely and the left side of my face swells from my left eye to the left side of my neck. I call my mom and she suggests that I call an emergency 24-hour dental service. Soon, I find that all of the 24-hour emergency dental services in the Saint Louis area are open from 7am-9pm. Not helpful; the 24-hour label is very misleading. I call my dentist’s office and leave a message on the emergency line. The on-call dentist calls me back in 15 minutes later (so kind, I thought!) but turns out to be epically unhelpful (not so kind…). As I explain what’s going on, he says: “no, I don’t know what you’re talking about.” I don’t understand, I was calm and clear. I’m not crying either; how can he not understand? With an unnecessary attitude, he replies: “we already gave you Tylenol 3, just take it every two hours.” It’s labor-day weekend and dentists are closed through Tuesday. It’s Thursday night. I can’t take copious NSAIDs every two hours for four days. That’s insane! There is So-Much-Pain. I tell him that I don’t feel comfortable taking so many pain meds and NSAIDs. I say that I’ve already had stomach pains in the past few weeks from taking so many NSAIDs and I just don’t feel comfortable. There has to be another solution (yay for assertiveness). I also tell him that my pain tolerance is high, but that I do not believe I can tolerate this level of pain. I tell him that I’m scared. That I do not want a pain-med bandage and that my mother thinks the tooth might be abscessing, especially because of the swelling. What does he think? He didn’t seem to think what I am describing is a big deal. Needless to say, I will not recommend anyone to this dental office. Trying to reassure myself, I ask him if my swelling seems like something familiar to him. He says no. Seeing as my swelling is in my face and it does not even sound familiar to my dentist, I ask if he would recommend the ER. He tells me that the only thing doctors at an ER will do is give me pain medicine and brings the conversation full circle: “Just take your Tylenol 3.” I am not okay with how this conversation is going. I’m not going to poison my body for 4 days just because he’s busy and dismissive. When we hang up the phone, I called my mother to tell her about the conversation and she says: I don’t care what he says, just go to the ER. So I went. They ended up checking for an abcess and giving me a Perocet to manage the pain until I could get into a dentist. I passed out for an hour or two and woke up sweating, feeling woozy and with a very upset stomach.

Now, individuals who have been abstinent for over two years but who have been purging for most of their lives will understand how frightening it is to feel sick to your stomach. Frantic thoughts of: “No, this is NOT ok, this is not okay…this is NOT okay” and “I will WILL myself not to throw up, I will WILL myself, I will fucking WILL MYSELF AND I WILL NOT PUKE…” swing like pendulums through your head, increasing momentum as the pain in your stomach increases. Vows of: I will never forget to eat a snack before a Percocet ever again. I reached for the granola bar and banana that I brought with me and made my way through the banana. A nurse brought me water. I was taking deep breaths, imagining that oxygen was surrounding and massaging my red-hot stomach. 

A moment later, I was retching bananas and stomach lining. It was awful. I pressed the call button and let my nurse know. She came about an hour later and discharged me. I got to my car, sat in the front seat and drank some water. Driving home (and no, in retrospect…I should not have been driving because I was high on Percocet), I started retching again. I grabbed a plastic bag from my back seat and retched bananas until I got home. This is the most undesirable of situations. No one wants to be puking in their own car. No one, especially no one in honest eating disorder recovery, wants to be puking at all! It's scary! It was almost 8am by the time I was home; I was immediately on the phone with my mom and the dentists. We were finding an endodontist to fit me in for an emergency root canal. 

Once we found one, I called the office to tell them how sick I felt and that I had been throwing up. When you’re giving your medical history, ripe with eating disorder history, and you add that you’ve been sick to your stomach lately…shame comes up. It did for me. I wondered: what if they think that I’m lying? When I was living in my disease, how many times did I lie to others and myself? How many times did I say that I was fine? Innumerable times. I’d find myself “free” of behaviors for about three days and would jump to the overly-hopeful conclusion that things were perfect; that I was in control of my eating disorder and that I did not need help. I jumped to conclusions because I was desperate to be free of a secret that I shamed myself for having. It makes me sad to think of that time. These are the times that compassion is most significant. Not the times that you're feeling accepting of compassion, but the moments when you're retching in a dentists office, running on no sleep and feeling ashamed. The times that we need compassion the most are the times that we want to give it to ourselves the least. I felt my feet on the floor, I felt my heart in my chest, I felt my breath flow in and out of me and I willed myself to be kind to me.

So, driving to the endodontist's office, I had to pull over once to get sick. Once in the office, I had to jump up and scamper to the bathroom before the root canal. This was awful; I felt embarrassed. Luckily, the endodontist completed the procedure in about 15 minutes. So long as I was not even swallowing saliva, my stomach seemed to stop somersaulting. As I left the office, I felt overwhelming relief. Mission accomplished: I conveyed self-compassion even though I was being witnessed in an undesirable situation, and I did not vomit on the endodontist during my root canal. Phew. I took a few deep breaths and waited for my AC to work. I also tested sipping on some water. St. Louis is in a heat advisory; I hoped it would be okay. About five minutes after I drank the water I had to pull over and get sick again. This part was so incredibly awful, for the duration of my ride home, it was mind-over-sick-stomach. I got home, fed kitty, threw my clothes in the washing machine and crawled into bed. I curled up into a ball, fell asleep, and woke up 7 hours later. 

When I woke, I ached in my jaw, but it felt like a healing kind of ache. An ache from the procedure and not the infection. I felt much better in my stomach. My phone said 6:00pm and Kitty meowed for more wet food. She sniffed my face and pounced around for a bit; I watched her play. I cautiously sipped Gatorade and water. Then I moved on to crackers. It was at this point that I noticed that my eating disorder voice had not come in to manage my chaotic day, which is what used to happen. Neither had my shame and self-hatred parts merged in to manage the situation. Yes, I felt the shame; but it did not debilitate me. The thoughts did not take over. This is a major achievement. I'm glad that these processes are stepping back in even the more intense situations.

So, back to the vein of eating disorders: I had not eaten in hours, which frightened a part of me. I thought: what is to come? I have not yet experienced such SICK-like symptoms in eating disorder recovery, how will my eating disorder respond? Will it react? I moved from fluids to crackers to soup and my mind flooded with memories. How many times had I been sick, really sick, in my eating disorder? So…many…times. But in the past, I had counted crackers, counted calories; my body longed for bland sustenance to carry it through the flu, a cold, being-overextended…and I didn’t know how to give it what it needed. Why? I was too frightened. I think that self-compassion frightened me. This is a relevant concept for all of us to reflect on: why is self-compassion sometimes frightening? Unless we have an internalized companion who validates our self-compassion, it's really frightening. And why? Why have I told myself, "I'll be easier on myself next time...next time...next time." Or, comparing in my mind: "well, so and so is not taking it easy on him/herself, why should I?" I thought about how in my last life, the authority I had over food and my ability to refuse what my body asked for had been the few areas that fueled my sense of self-efficacy. It was a sense rooted in self-hatred, but it was there. And yes, it’s sad. But it doesn't bubble up from nothing. So if you can relate, ask yourself: what have I seen and experienced in my life that might have caused me to relate to myself in this manner? It's helpful to develop an understanding of where your versions of self-hate and compassion were formed and transmitted to you. Where did you learn them? I'm not saying that we are not inherently loving; I happen to believe that we are. But the stories that come along with self-hate and compassion are learned. They come from somewhere.

For me in particular, I feels sad that for so long, my sense of beingness was eclipsed by an urgency to escape my body. I would not tolerate being in a body. I would not be without self-judgment. During the time after I woke and begin to think about feeling sick and being Compassion, memories flashed by, I remembered Tara Brach saying, “if you are caught in your mind, you cannot feel your beingness.” There are so many thoughts that I can share about my perspective of the mind; but for now, just let me say that I agree with Tara. Breathe-in; breathe-out. Take a moment. Anyway, I sat alone for a moment and felt what was going through me; I also shared what was going on internally for me with my roommate. Then, I reflected a bit on the recovery process.

Eating disorder recovery is a lot like starting a life over. It means being committed to living your life by new rules: core beliefs that have been uncovered and re-processed in a compassionate frame. Many of my peers (and me too!) have expressed the following hang-up at several points over the course of the first few years of recovery (actually, a friend of mine said this to me a few weeks ago): “I feel stuck. I realize that I am stuck because I am trying to live a recovered life by the same rules that I followed in my eating disorder.” This is not uncommon. We forget to challenge old processes. Our content is new, but we revert to the old dis-compassionate core beliefs. For instance, something a person may do is attempt to manage herself into compassion. Here, Self-compassion is a comparatively new aspiration, but managing is an old process. First of all: No, internal managing is not sustainable. It doesn’t work. Letting go works. Yes, the desire to manage happens anyway. Sure, this sounds counter-intuitive because compassion is not about managing and avoidance. It’s about being mindful and open and welcoming. But like I said, it happens, and it looks something like this: when shame comes in, you might feel the pressure to make the shame go away because you know that compassion is the answer. It’s either loud or it’s quiet and insidious. You might shame yourself for having shame. You might compare. You might feel a low grade sense of inadequacy. You might be attempting to compensate. These are examples of “the old rules;” the old processes. The rules that perpetuated, for instance: the eating disorder. How did it do so? Because it’s a punitive process and punitive processes will always perpetuate addictions: eg – “if I can just make this situation GO AWAY then I’ll be okay; if I punish myself for engaging in XY and Z then I’ll stop and everything will be okay.” Again – no, this does not work. Alternatively, the compassionate discipline is to say: “I’ll witness what is here, I will develop an understanding of it. If I witness my desire to punish myself, then I can resist. I’ll remind myself that it’s okay for the punishing voice to be there, but that I do not need to react to it. I do not need to make the voice go away, I need to sit beside it and give it the curiosity and patience that it deserves. I’ll practice self-directed patience and loving-kindness. I'll do it even if doing so feels wrong with every fiber of my being. I’ll do it even if I’m scared…even if I hear a million justifications to do otherwise. I’ll just do it. Why will I do it? Because I trust that one day, this self-caring process will replace the self-loathing process. I know that self-hate is cultural and learned; and I know that I have the courage to wait for my brain to re-learn, to patiently wait for it to pave a new neural pathway.” So, here is the answer when it comes to recovery processes: Be willing to restrain from reactivity; be willing to Witness with compassion instead of engaging in self-deceptive punishment. Be your compassionate healing presence. Even during times of pain, even if you're buckling over in public and in pain, pain, pain: be your own accepting witness. Tara Brach calls this the willingness to “say yes in a cellular way.” Imagine that. Imagine your cells taking on the form of yes, of cradling you within yourself. Saying yes in a cellular way, I love that.

So, re-living old memories but responding to them from a compassionate frame of mind is the subject. That’s what was happening to me when I woke up from my nightmare day. Witnessing my memories of punishing myself while feeling sick. They were there and they needed to flow through. I thought about the difference between memories that happen often and those that come up from time to time. Some memories are called into line on a daily basis because of our daily activities. Specific to eating disorder recovery: dressing and eating and interacting with peers happens daily. We frequently hear a neighbor’s orthorexic soapbox performance. Your surroundings are full of many of the old rules: such as: my nutritional intake is a part of my identity. Drinking kale makes me more whole. McDonalds makes me less. I hate myself for eating that; I shouldn't have eaten that. I don't have a weight-bias (...but you do). Most of social media screaming: look at me...but only from this angle and only with this camera filter. Instagram photos of vegan accomplishments. People wanting other people to know the way that they eat; that they're clean. Most women are at war with their bodies. I could go on and on and on; the loathing is everywhere. Its everywhere and what's worse is that it's often masked with a self-caring facade. Still, if we do our best to speak to ourselves with compassion when we find ourselves faced with these insidiously self-hating scenarios (instead of feeding into the scenarios), we will quickly habituate to the memories that orient around these subjects. They will not arise as often nor will they sting us with as much force; we will become familiar and we will remember the importance behind the compassionate choice. We can actually correct the moral of our old story and create new meaning. The old memories will only continue to arise as an old friend asking for help. Meanwhile, other memories are attached to infrequent happenings. It takes longer to habituate to a new compassionate perspective when it comes to experiencing such rare-happenings. For instance, as time goes on, a rare-happening (like getting as sick as a dog) is more likely to recall painful memories then getting dressed in the morning because it simply arises less often. So, it makes sense that during a time of feeling sick, I would be flooded with sad memories about refusal to give myself sustenance. It'll take me a few years to get used to this sort of thing because luckily, it does not happen often. This is where patience is important. Recognize that any experience might bring up the past, but that you have the courage and tenacity to continue to connect to the present moment and just be with whatever arises. Unblending and being...unblending and being, and breathing.

Well, a surprising thing happened when my memories flooded in: I did not feel a desire to manage my intake. I feel extremely grateful. Are you surprised? I was. Yes, I know that my recovery is strong, but I thought that my eating disorder voice would have peaked its head out; I thought it would come onstage. Today was a horrendous day, it would have made sense. I was shocked that I did NOT have a single eating disorder voice! I feel so grateful for my eating disorder because she trusts me to manage things without her protection! Then, I stop for a moment: come-on…hang a question mark on this. Make sure you are being honest with yourself....Aaaaaand: nope, nothing. Being honest with myself!! Wow. Yes. Okay...Wow, this is major. Singingggg!! I believed I would need to accept and work through a voice that states something like: “please, carry these dietary restrictions into our daily life.” I believed I would need to work with this restrictive part of me. To work through it’s arrival. To my surprise, this did not happen. Not even for a moment. I get that the fact that it did not come in is my preference, I also understand that everything would have been okay if it did come in. Things are really changing. Over time, things change. They really do. I don’t know how else to explain how extraordinarily worth-it it is to white-knuckle-it for years through all of the fear, anxiety, suffering and pain. There is another side. And, on the other side, there is a commitment to tenacity and love. A commitment to re-instate compassion. There are hopeful surprises. There are awful days when the unheard-of happens: when you are automatically compassionate with yourself without even having to think. Moments when you think to yourself, wow, all of the hard work I put out there gives itself back to me. Compassion is grateful that I have used it, and it reflects itself back to me when I really need it. Thank you, Compassion. All of this is really sinking in, it’s really coming together and I am continuing to heal.