Hey guys hope the week has been kind to you all?
No midweek update this week, i thought i would put it all here today.
So to Monday…. Appointment with the eating disorders doctor.
Now the day did not have the best of starts. Anybody who knows me well knows i am not to savvy in the kitchen. Monday morning starts in a very routine way. Porridge and a cup of tea. Now as i completed the first step of this mornings porridge putting it in microwave for the allotted time. The timer sounded……. as i pulled the bowl out to stir for before repeating, something did not look quite right. Looked a bit thick i thought??? Oh well i thought, give it a stir maybe it will be ok after the repeated process………. So it went back in. Well what can i say…….. i pulled out the bowl and looked down to what can only be described as something resembling cement!!!! God knows what happened? But that was the consistency. So i tried again!! Sublime to the ridiculous is the only way i can describe it i guess…… From cement it was now so watery i could have watered the garden with it. After this i was in no mood to try again, i settled for an apple. As we all know this is not the prescribed breakfast staple. I knew as i wrote in the food diary i was going to get some for this from the doctor. Quite rightly too!!!!! So bad was this morning i missed my breakfast tea due to the knock on effect of my mishap. I arrived at work not feeling great, 1 apple was nowhere near enough nutrients for my weakened body. My appointment was at 9:30 am so i had plenty of time to make a tea which i did. With tea made i set about my tasks which i needed to do. I had around 20 minutes before i had to leave to make my way down to my appointment.
As i left for the appointment i was unsure what the outcome of this next session would be? Had i lost more weight? Gained? Or stayed the same? The dark side of my mind was hoping i had lost!!!! I mean that is where i am at with this illness after all. I arrived at the hospital to be told my doctor was running late. Superb!!! More time to think!!!!! It turns out i was only waiting 10 minutes! Still long enough though. So the short wait ended as i was called in. As i made my way in to the consulting room i was really feeling exhausted, low, depressed. The doctor sensed immediately that something was not right. She asked me what was wrong? So i started the tale of Monday morning………………………..
Once finished she quickly reassured me that for whatever reason this happened i was not to dwell on it. We got on with the meeting by having the weigh in!!! Result? I had gained a 1lb. Not a lot, but a step forward. I was now back to 7st 7lb’s. This was the weight i was when i was assessed 2 weeks ago. This pleased her……. I on the other hand was not 100% sure about how i felt about this???? Yes the weight needs to be added but god it is hard to convince the brain that this is the right direction. I am aware i am repeating myself, but the thoughts are still there. She suggested adding another step if i felt comfortable? I was unsure but agreed. She felt i needed to add a mid morning snack. She placed on the table selection of options she felt were good snacks for mid morning. I looked at each of them firstly checking the calorie content. Every single one the amount of calories freaked me out!!!!! I mean the highest was 212 calories!!!! I dismissed each one. We discussed this and what other options there were and finally decided on dried fruit. Yes it does not sound great but it is what made me feel comfortable. Apricots were the chosen fruit for the snack. I was to eat the whole pot not just a few. I was not comfortable with this suggestion but she insisted this was a positive step that needed to be taken now…………………………. We moved the discussion on to how i had been feeling and coping with the steps. She feels that as soon as we have sorted the eating and that my body is out of starvation mode, the next step on the road to recovery is to have Compassion Focused Therapy (CFT). Now at the beginning of this journey i had been offered Cognitive Behavioral Therapy (CBT). CBT she informed me is not the type of therapy for me. CBT encourages you to think more as it were, this is no good for me as i am a classic over thinker….. Now CFT is different as this brief description explains……………………
Compassion focused therapy (CFT) is a system of psychotherapy developed by Paul Gilbert that integrates techniques from cognitive behavioral therapy with concepts from evolutionary psychology, social psychology, developmental psychology, Buddhist psychology, and neuroscience. “One of its key concerns is to use compassionate mind training to help people develop and work with experiences of inner warmth, safeness and soothing, via compassion and self-compassion.”
The central therapeutic technique of CFT is compassionate mind training, which teaches the skills and attributes of compassion. Compassionate mind training helps transform problematic patterns of cognition and emotion related to anxiety, anger, shame, self-criticism, depersonalization, and hypomania.
Biological evolution forms the theoretical backbone of CFT. Humans have evolved with at least three primal types of emotion regulation system: the threat (protection) system, the drive (resource-seeking) system, and the soothing system. CFT emphasizes the links between cognitive patterns and these three emotion regulation systems. Through the use of techniques such as compassionate mind training and cognitive behavioral therapy (CBT), psychotherapy clients can learn to manage each system more effectively and respond more appropriately to situations. There are an increasing number of empirical research papers that demonstrate the importance of compassion as a way of directing behavior to deal with threat and resolve conflict.
Compassion focused therapy is especially appropriate for people who have high levels of shame and self-criticism and who have difficulty in feeling warmth toward, and being kind to, themselves or others. Such problems of shame and self-criticism are often rooted in a history of abuse, bullying, neglect, and/or lack of affection in the family. CFT can help such people learn to feel more safeness and warmth in their interactions with others and themselves.
Numerous methods are used in CFT to develop a person’s compassion. For example, people undergoing CFT are taught to understand compassion from the third person, before transferring these thought processes to themselves.
Now as you can see from the explanation, this is clearly the best for me in my eyes. The high levels of shame and self criticism are bang on with how i am and have been for many many years going right back to my school days. Personally i am not 100% sure this will work as i feel i am a terminal case. However it is a path on the journey that i must take a little wander down to see where it leads?
Here is just a quick explanation of CBT. As you will see there are differences which show why CFT is better for me……………
The CBT model is based on a combination of the basic principles from behavioral and cognitive psychology. It is different from historical approaches to psychotherapy, such as the psychoanalytic approach where the therapist looks for the unconscious meaning behind behaviors and then formulates a diagnosis. Instead, CBT is “problem-focused” and “action-oriented”, meaning it is used to treat specific problems related to a diagnosed mental disorder and the therapist’s role is to assist the client in finding and practising effective strategies to address the identified goals and decrease symptoms of the disorder. CBT is based on the belief that thought distortions and maladaptive behaviors play a role in the development and maintenance of psychological disorders, and that symptoms and associated distress can be reduced by teaching new information-processing skills and coping mechanisms.
When compared to psychotropic medications, review studies have found CBT-alone to be as effective for treating less severe forms of depression and anxiety, posttraumatic stress disorder (PTSD), tics, substance abuse (with the exception of opioid use disorder), eating disorders, and borderline personality disorder, and it is often recommended in combination with medications for treating other conditions, such as severe obsessive compulsive disorder (OCD) and major depressive disorder, opioid addiction, bipolar, and psychotic disorders. In addition, CBT is recommended as the first line of treatment for the majority of psychological disorders in children and adolescents, including aggression and conduct disorder. Researchers have found that other bona fide therapeutic interventions were equally effective for treating certain conditions in adults, but CBT was found to be superior in treating most disorders. Along with interpersonal psychotherapy (IPT), CBT is recommended in treatment guidelines as a psychosocial treatment of choice, and CBT and IPT are the only psychosocial interventions that psychiatry residents are mandated to be trained in.
So Tuesday dawned with a meeting at work to start the day. I had to be in early, not a problem. Up and out! Burn more calories……………….. Oh yes i am back to this level this week. I have no idea what has caused the regression back to this stage but i am here. So lets try and climb back from the abyss. With the meeting concluded i carried on with my day focusing on the tasks that i needed to do. Burning into my brain was the need to keep moving. Now as mid morning approached i found myself clock watching and starting to worry about the snack!!!! I mean ridiculous right?????? Well tea turned up and “drum roll”!!!! I had 5 apricots!!!!!! I know i know this is not what was agreed with the doctor going forward but i just felt that this was enough to start with……. I felt an odd satisfaction that i had achieved another small step, on the flip side, the guilt was encroaching as is standard…….. The daily battle with food is the hardest thing. I just do not get how something which is life sustaining can be in total control of my brain 24 hours a day. But this is the juncture i am at and i have to try and move past it.
Wednesday was a horrible horrible day. To start with i woke like i had been on a 50 mile hike, tired, aching, the works. Being my day off chores were on the list………..Needless to say these chores did not go to well at all. Simple everyday tasks were transformed into huge mountains that i was struggling to climb. Stress levels high along with tight chest and palpitations which frightened the life out of me!! I managed to talk myself down to a calmer level. I knew one thing……….. I had to get out of the house. After all i was picking number 1 up from school and spending the rest of the day with her as her mother was out for the day. Couldn’t really do that from a hospital bed could i now?? I retreated up town to the coffee house..Usual perch and attempted to take my mind off the mornings “issues”. As i sat and chilled i got to thinking ahead to my upcoming appointment with the dietitian was going to pan out? All sorts going through my head, are they going to make a diet plan that i have to follow no matter how i felt about it? I am not really sure i could do that? I am just going to have to wait and see. You cannot second guess these things. The time arrived to go and pick number 1 up, this is the highlight of my day of course………As it was extended time with her i was very much looking forward to it. Nothing special planned but it was just nice to be able to see her for longer mid week. One thing that was playing on my mind was dinner! Of course number 1 had to be fed, but i was freaking out about what i could have that would be sufficient?? Madness!!! My thoughts totally consumed by the “diet”. We ended up going to a restaurant that we had been to before, i knew the menu!!!!! How sad is that? I go to a place where i know the menu off by heart. I ended up just having soup and a side salad!!!! Shocking!!!! Trouble is i am just not hungry these days. Part of the starvation mode you see. We finished dinner and made our way home, we had a bath and some reading to fit in before bed time. Just to be able to do these things makes me happy, it is great to be part of number 1’s routine. With these done we made our way to bed around 7:30. We sat in bed and chilled out watching a bit of TV before she settled down to sleep. Around 9:30 number 1 sound asleep me watching barbie on TV, i couldn’t find the remote to turn it over number 1’s mother returned. Progress report of the afternoon and evening done i bid her farewell and drove home. As i drove home i did not have the usual depressed feeling i get when i leave her. I think i put that down to the little extra time we had together that day.
Thursday, Friday, and Saturday were pretty non descript days to be fair. Work dominated along with the usual food and calorie led thoughts. I have to admit i have not been having the mid morning snack and i have also cut the orange juice from the routine. Saying something positive and accepting positive things that people say to me has also disappeared. Not sure if its all to much at the moment? My head is cluttered. I have also taken to not sitting down to have lunch at work. For the last few days i have had lunch on the go. Eating in between serving customers and doing various tasks. This harks back to the previous Saturday where i was so busy. This of course is not healthy, for some reason though i feel happier. In the back of my mind i know exactly what i am doing. It is not right, but i cannot stop myself…………….Let me explain it simply. I am aware that i am gaining weight all be it slowly and for the good of my health. However as much as i need to gain this weight i do not want to………..So so warped!! That is the bottom line of it all! Do i want to get better??? My brain is telling me no!! I just cannot get to grips with it all, i genuinely believe i am going mad………Where’s that straight jacket??? Since being told at my last appointment that i had gained weight 1lb!!! That is all it is, i am back to body checking i feel i look fat and am indeed fat too. This is dragging me back towards the edge the horrendous week has not helped. Other bits and pieces happened that have tested me to the limit but i am not willing to share these i am afraid.
Sunday with number 1, my sister, and nephews was spent in a fog of avoiding food and trying to burn as many calories as i could. I am going backwards here. I am convinced of it!!!! The worst part sitting here typing this blog is that i really do not care……………………..
Messed up way to end guys. Sorry i am letting you all down……….Typical Matt.