Psychotherapy: Take 4 πŸŽ¬

Today I met my ‘new’ therapist and had my first session. Oh my goodness, it couldn’t have come at a better time!! This week, since coming back off holiday and the build up to starting weekly therapy (again), has been horrific!!! My eating has been all over the place, my mood has been in my boots and my life has felt like one, big, disorganised mess – in almost every aspect.

Therapy wasn’t as horrendous as I’d built myself up for it to be (you’d think I’d know that by now having been through it before, but, theres a bit more irrationality for you). In true Caitlin style I was running a couple minutes late which meant I didn’t have to endure the anxious wait in the waiting area, so for once my poor judgement of time was welcomed! As you can imagine, speaking to someone you’ve never met before, about quite personal circumstances, thoughts and feelings isn’t the easiest thing in the world. I didn’t open up as much as I could have but I’m sure that will come in time. We mainly spoke about what I wanted to get out of therapy and where I am at now (it would appear we have our work cut out!) and touched on how I felt about being there. It’s safe to say I was a big, mixed bag of all kinds of emotions. Fear, anxiety, optimism, hope, embarrassment and everything in between! Having had 3 lots of CBT on separate occasions previously, with varying levels of success, I knew what to expect, yet I still couldn’t help feeling pretty overwhelmed!!

I had my first round of CBT with CAMHS when I was first diagnosed with bulimia and depression. My therapist was brilliant! She saw me through my pregnancy with Harvey (he was born a good weight despite being early – so I’d say that’s a success) and following that I transferred to the adult team (after a couple of months ‘off’) and started the 2nd round of CBT. This time, my mind wasn’t in it, I was trying to raise a baby and figure out how to do this mum thing, hence I didn’t engage very well. However, I was stable and my eating wasn’t a massive cause for concern. I managed ok on my own at that point. I relapsed in 2013/14 and yet again started CBT which helped, to a point. However after a while I didn’t engage very well but fortunately managed to get myself back to a steady ground and had plodded on since then until the beginning of 2018 and POW! Right back at square one!! This time round it’s not CBT but Interpersonal Therapy I’m giving a bash instead. Which focuses more on thoughts and feelings, understanding the ED and is a bit slower paced, so I’m holding out hope. They say 3rd time lucky but maybe one extra for good luck too?!

During the past week I have completely lost any kind of routine or structure. Harvey has broken up from school and we’re back from Holiday so its been a double whammy of routine change! I don’t deal very well with change at the best of times (especially when it comes to mealtimes) let alone when I’m already struggling. Life over the past week has been like, you know when you fling all your necklaces in a jewellery box, then end up spending 6 hours, recruiting 3 friends, having 2 tea breaks and muttering some explicit words in the quest to untangle them and in the end just give up – well that kinda gives you an idea of how disorganised life is at present. Meal times are non existent (we’ve adopted a very counter productive ‘if you’re hungry make a snack’ approach, which for obvious reasons isn’t sustainable or effective), my thoughts are all over the place (my heads in the clouds, I don’t know what I’m thinking half the time and can’t even keep up with myself, so apologies to anyone around me), my house looks like a bomb site (well maybe not quite that bad but there’s an awful lot of half done tasks that I’ve lost focus on or not had the energy to finish) and I have no idea which end to start to untangle first!!! I guess one of the most valuable and important structures to rectify initially would be that of meals, for 3 simple reasons: 1. You need to eat to live – no brainer. 2. I don’t want Harvey to get used to these bad habits, and 3. Structured mealtimes would naturally give the rest of the day some sort of format. The main aim to re-establish some sort of mealtime routine and regular eating, with the plan being:

  • Try to eat with Harvey
  • Distract myself after tea, while harvey takes his 3 hours to eat his 4 plates of dinner and 2 puddings.
  • Plan meals, where possible
  • Don’t go longer than 4 hours without eating
  • Get straight back to plan even if I’ve binged or purged

During my therapy session today we established that I haven’t eaten and kept down a meal at all in the last week – it’s been mainly yogurt and fruit, which aren’t exactly the most calorific food sources, hence we came up with a meal plan. This is step one – the end goal is much further off but even so this seems daunting enough, starting from where I am and the thought of eating so many times during the day (although I know its a ‘normal’ eating pattern), scares me quite a lot. It seems like too much food (says irrational ED Caitlin), but I know its still not enough to meet my nutritional requirements (says head-screwed-on, dietitian Caitlin) – the ongoing mental battle reappears! This is what I’m aiming for:

  • BREAKFAST: Porridge or fruit and yogurt
  • MID-MORNING: 1 rice cake (2 if no breakfast)
  • LUNCH: Mini wrap, falafel/chicken mini fillet/tuna and lettuce, with fruit
  • MID-AFTERNOON: Yogurt or Nuts
  • TEA: Ready meal or pre portioned meal or jacket potato
  • EVENING: Biscuit or rice cakes or toast
  • (Drinks at each meal/snack)

Since being home from holiday I haven’t actually managed to cook a meal for anyone let alone myself (I’m a massive feeder and used to love cooking but that’s gone out the window as of late, hence the ready meals/pre portioned meals at tea time). This poses its own problems especially when it comes to sustaining a growing, active-all-hours, 6 year old. Fortunately, I have had my amazing family and wonderful friends to help out. Harvey has been spoilt rotten with BBQ’s and meals out – I don’t think he minds that though! In therapy today, she asked me what I want to achieve and the 2 things that really hit the top of the priority pile were to be able to comfortably cook and bake again and to be able to effectively manage the eating disorder, thoughts and feelings. After battling it, on and off, for so long, I know it will never completely disappear, I accept that – it will always be a part of me but if I can manage it in a way it could lie dormant, as opposed to the explosive state it’s currently in, that would be suit me fine.

The battle doesn’t just stop at meal times though. As I mentioned earlier on, my mind is a big, tangled, confused, disorganised, unfocused disaster at the minute, which doesn’t help the whole eating situation. My thoughts are flitting from one place to another constantly, I am finding it difficult to focus on one thing at a time, fully! Since starting to write this post I’ve gone off and hung some washing, made a cup of tea, filled in my food diary, run Harvey’s bath and spent 15 minutes staring out the window (all you can see from our windows are the tips of trees and the sky or most the time mainly clouds – so not all that enthralling), which gives you a bit of an idea as to where my concentration, or lack of, currently sits! Sitting down and eating is enough of a challenge as it is without thinking about a million and one other things during a mealtime. On the other hand though theres the state of absent mindedness – if its not thinking faster than I can keep up with its losing myself in thought of something else. Have you ever done something, maybe walked or driven somewhere and when the task is done or you arrive, you have a very vague, fuzzy recollection of the process or getting there? That’s what my days have been like. Its almost as if I have been breezing through without really seeing any of it. It all seems like a dream or a really vague distant memory, which, when it hits me, is actually quite frightening! Meaning mealtimes and the process of eating and making food has been even tougher, on top of the negative food thoughts, guilt and anxiety. I imagine theres a proportion of it down to malnutrition and some due to sleep deprivation.

I’m not entirely sure what sleep actually is any more?! In line with the general theme of my life, it’s chaotic. I often wake up early hours in the morning, if I actually manage to get to sleep before that, and spend an hour or two tossing and turning until I finally decide to throw in the towel and admit defeat. I start getting annoyed with myself and then stand even less of a chance of sleeping so, I get up for a bit, before trying at sleep again (I have a 50/50 success rate second time round). The outcome – a very tired me the next day. We all know first hand how happy we are when we’re tired (not!) and those sugar cravings that come with tiredness, which only fuels the binge/purge cycle. Along with not having the motivation or energy to actually make meals. The result? Long periods of food restriction, followed by falling into the B/P trap and again another sleepless night due to hunger, physical pain, negative emotions and disappointment in myself.

My motivation and drive this past week has been at an all time low but following on from today I am determined to at least attempt to put the plan into practice. Hopefully getting a bit of meal structure and regular eating back in place will help ‘fix’ everything else. Time will tell. I’ll let you know how it goes. Right now I’m off to get my meal plans done.


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