On this episode, we’ll be sharing a story of recovery. Dr. Karen Nelson is joined by Jane who will take us through her journey of diagnosis, treatment, and what it means to live in recovery.
On this episode, we’ll be sharing a story of recovery. Dr. Karen Nelson is joined by Jane who will take us through her journey of diagnosis, treatment, and what it means to live in recovery.
For a transcript of this episode click here.
Dr. Karen Nelson 00:01
Eating Disorders thrive in secrecy and shame. It's when we create a safe space for honest conversation that will find the opportunity for healing.
Dr. Karen Nelson 00:12
Hi there. I'm Dr. Karen Nelson, licensed clinical psychologist at Melrose center, welcoming you to Melrose heals, a conversation about eating disorders, a podcast designed to explore, discuss, and understand eating disorders and mental health.
Dr. Karen Nelson 00:29
On today's episode, we'll be sharing our recovery story. I'm joined by Jane, who will take us through her journey of diagnosis, treatment, and what it means to live in recovery.
Dr. Karen Nelson 00:41
Now, before I begin, I invite you to take a deep breath, and join me in this space.
Dr. Karen Nelson 01:01
Welcome to the podcast. Jane, I am so excited to have you here with me today, as we're going to be talking about your journey of recovery.
Jane 01:10
Thanks so much for having me on. I'm glad to share my story and hope it might help anyone who is struggling with an eating disorder or working through recovery.
Dr. Karen Nelson 01:19
You know, first of all, I just want to say I'm deeply honored to be able to sit with someone who has moved through eating disorder recovery. And I'm so grateful that you are here with me today to share your story. You know, as we start talking about your path through the eating disorder, maybe let's start at the beginning. When did you notice the eating disorder evolve or start to develop maybe take us there first.
Jane 01:56
So I was in my mid 20s, I was working living on my own during that time, and it for me was a very kind of flip a switch sort of transition into not necessarily that my eating disorder evolved that quickly. But the behaviors that would come to characterize my eating disorder kind of became a part of my habits and routine very quickly. I went to the doctor for my annual physical, and I didn't like the number that I saw on the scale. And during that appointment, I said to my doctor, I think I might like to lose a little bit of weight. And she said, Well, how much do you think you want to lose? And I on the spot came up with a number. This wasn't anything that I had been really thinking about prior to that. And so I throw out a number and she said, that should be fine. I don't know if she had any other kind of caveats or suggestions or anything about it. And if she did, they at least weren't strong enough for that have to have been something that I held on to and really kind of took to heart as I was, all of a sudden on a diet crusade. I had never in my life tried to diet. So all of a sudden I was like, Okay, what are we doing with this? How are we going to pull this off. And I started tracking everything that I ate. That became a very quick compulsion.
Dr. Karen Nelson 03:38 So there was a place where it potentially started where there was a perception in your brain, I need to lose weight. And then kind of moving into some of those more restrictive behaviors. Does that resonate for you? Or tell me about that?
Jane 03:52
Yeah. I along with my decision to lose weight, I bought a scale because I didn't own a scale in my home before that. And I lived in a studio apartment. And my bathroom was pretty small and actually had a litter box in it because I had my my cat so I didn't have room to put my bathroom scale in the bathroom. And I put it in the corner of my kitchen because that was the other hard surface in my home. And it's just it feels like like a symbol of something. The fact that that was the choice that I made, because it's so important for me to have this available constantly. I'm gonna just put it in this very easy to access location in the corner of my kitchen. Gosh. And to think about it now it's just like, oh, that's Oh–
Dr. Karen Nelson 04:45
That's right.
Jane 04:48
So that became part of the data that I was tracking. And it starts out as as a piece of data but it then becomes part of the compulsion. So how many times a day even? Am I weighing myself? And thinking very, at a very minut level about what did I eat? And how is that impacting my weight in this in this moment and how kind of granular those those sorts of details were. And I did lose weight quickly. And I think a big part of that was that it was the first time I had ever tried to lose weight. And I think that happens for people that the first time you try, and in the short term, the very short term, we're talking, you know, a few weeks or a couple months after I started this process, that in that very short term, I did lose weight, and people noticed, and they commented on it. And I loved it. And it fed into that feeling that I was doing the right thing. And, of course, these people meant well, and they were intending to compliment me. And I took it that way at the time. And I see now how that's problematic to make comments about people's bodies, even if you think you're complimenting them,
Dr. Karen Nelson 06:37
I think what is really beautifully descriptive, as I hear you kind of sharing that story about, you know, making a decision to lose weight, purchasing a scale, my scale shows up in my kitchen. And that, you know, I think it's good for us to distinguish there's nothing inherently wrong with scales, right. I mean, a scale is a scale. But what I hear is how quickly that tumbled into almost obsessive behavior. And that desire to maybe obsessively check weight, or, you know, feel restrictive in the foods that I'm eating, in order to manipulate what is happening on this scale.
Jane 07:07
That's exactly right. Yep.
Dr. Karen Nelson 07:10
Absolutely. And, in addition, I love the insight that you have now of how, ultimately, starting to receive some of those comments from people sometimes feels confusing of like, Wow, maybe I should keep engaging in this behavior, or what was that like for you?
Jane 07:37
It definitely felt like I was I was doing the right thing. And that around the margins, as I was making choices, with my food, I was still trying to pay attention to nutrition, and that kind of thing, like, Ah, well, I can't just, I can't just eat nothing, I still need to make sure that I'm looking at these various various elements of nutrition. But when things became more restrictive, and it became harder and harder to even pretend like I was paying attention to those elements. And the purely restrictive part of my eating disorder right at the beginning, honestly didn't last very long. I think it was maybe a couple of months. And that became just really hard as my body started to resist that. And I then the next kind of phase of my behaviors was this restrict binge pendulum, where I would have goals about the, you know, restriction that I intended to do throughout the day or throughout the week. And that would give way to kind of frantic and chaotic binge eating. Which then comes along with all kinds of, you know, feelings of guilt and shame and failure against the restriction that you were trying to achieve.
Dr. Karen Nelson 09:12
Well, one of the things that we talk a lot about at Melrose and just what we understand about eating disorder, behavior restriction, often leads to binging right that that if I'm not allowing myself to have a variety of foods or you know, enough calories, quite frankly, throughout the day, it's a natural body response for me to want and seek food that that is just biology. It sounded like you started to experience that.
Jane 10:00
Absolutely. And I've I've found throughout my recovery, that that part about variety and satisfaction can be just as important as the number of calories eat having enough it throughout the day, that I did a lot of things trying to trick my body into being happy with the diet or healthy version of things. If, if what I really want to have is a pop tart, I'm gonna go in all of these kind of weird manifestations that might trick my body into thinking that I've had a pop tart, and it doesn't work first of all, and you're probably going to end up eating the popcorn at the end anyway, so why just just eat the Pop Tart,
Dr. Karen Nelson 10.32
Let's maybe talk about how you did spend your time, in the midst of the eating disorder, maybe help us know what that looked like
Jane 10:41
At the time I was walking a lot. That was the kind of problematic movement piece of my of my eating disorder. It wasn't necessarily kind of the primary thrust. But there was an element of if I do X amount of activity that will help me quote unquote, earn X amount of food to balance that out those walks would be long, it was a another piece of data that I was tracking, I wasn't able to go for a walk without having the tracker on and it caused significant distress. If something went wrong with that GPS tracker, my days were very full of those kinds of, of behaviors. And I was fairly isolated from other people, because I wanted to be able to do my behavior. So I didn't have a big social life or anything like that. I was going to work, I was going to school and I was doing my eating disorder behaviors,
Dr. Karen Nelson 11.46
I think you bring up a really important point about a level of isolation, or almost kind of self exclusion sometimes, right? You know, we say it often eating disorders thrive in secrecy
Jane 12:06
The isolation that I was creating around my eating disorder, that's also really not helpful for anxiety and depression, that, you know, if you're having a low mood, or a lot of worry, being alone in your apartment, is a challenging way to experience those things. So I got to kind of a, a breaking point with like, I can't move forward feeling this way anymore.
Dr. Karen Nelson 12:36
What do you think that turning point was for you, or when when you did identify, hey, I think I do need some support.
Jane 12:43
I don't think it was just one thing, I think it was just having built for long enough. And this is this is something that felt a little bit challenging when I was reaching out for help. In particular, with the eating disorder piece that it hadn't even really been that long. In the grand scheme of things, you know, you sometimes hear about people struggling for years and years before they're, you know, reach out for help. And so I had some worry that maybe it wasn't bad enough for me to, for me to need help. But I was just feeling really kind of low and hopeless and needed. Didn't didn't see a way to come out of that on my own.
Dr. Karen Nelson 13:33
So many of our patients identify that space of maybe questioning, or shame or confusion. And we know the eating disorder is in the business of keeping us sick and stuck. And so it will give us 700 reasons why it's no big deal if you're fine. And so it sounds like you really experienced that. Like is this a thing? Should I get help for it? Tell us more about that.
Jane 14:00
Yeah, so I worked with a general therapist for five or six months. She had some knowledge of kind of eating disorder behaviors, but she wasn't a specialist in the area. So we got to a point where she suggested that she had gotten as far as she could with me in working through some of that stuff. And she recommended that I you know, seek specialized eating disorder treatment and that feeling and that kind of thought that you get of I'm not sick enough. And this is the thing that everybody I guess I don't know if it's universally everyone, but it feels almost universal. Of no matter how sick you are, your eating disorder is telling you that you're not sick enough to need or deserve. Help. That is it. Yes. And it doesn't matter how long you've had your eating disorder or how short you've had your eating disorder, but how much is it impacting your life? And how long do you want to stay there?
Dr. Karen Nelson 15:14
Absolutely. I mean, the eating disorder has a very different agenda than recovery. And, and the eating disorder is in the business of minimizing its presence. And so I think you're right. I mean, I guess I don't have, you know, actual data. But I can say from lived experience, as an eating disorder therapist, the majority of my clients would resonate with that statement, I don't know if it's bad enough, I'm sure. Or that idea, or message sometimes that we should manage it on our own, or I'll figure it out, not that big of a deal. More minimization of it. Tell us what the initial assessment was, like, as you made that very brave decision to do some exploration around eating disorder treatment.
Jane 16:07
Yeah, so my intake was with a medical doctor. We I had a form that I filled out that told told her about kind of my behaviors and experience and just other kind of general stuff about my life. And during that appointment, I think they did an EKG to check my heart. And even during that appointment, I don't know if it was at that point where I actually got an official diagnosis. But during that appointment, we talked about this diagnosis of offset other specified feeding and eating disorder. Because you know, my particular behaviors and how that was impacting me physically, this kind of restrict binge pattern that I was doing, put me in that, that category. And she recommended outpatient treatment. So I started scheduling my appointments with a therapist, dietician and psychiatrist at that time.
Dr. Karen Nelson 17:26
So significant. What was that like for you to receive the diagnosis? What what do you remember about that?
Jane 17:33
In some ways, and this sounds odd, but in some ways, that was like, a validation of the fact that I was really struggling, that wait a second, if she's, if she's suggesting this diagnosis, maybe, the distress that I'm feeling around food, and how much of my time it's taking up, how much I'm struggling, maybe that matters. And maybe there's people here who can help me if I'm in the right place, if, if she really thinks that this diagnosis would fit me.
Dr. Karen Nelson 18:25
Absolutely. And so the eating disorder voice was wrong. Right. The eating disorder was trying to convince you no big deal. And then you receive the assessment with a specialist who said, You're in the right place, we can help you. Yeah, how validating, that can feel to be like, Oh, my gosh, this is a thing.
Jane 18:35
Yeah. And you're right, that the eating disorder will tell you, Oh, you're just have some have some weird, have some weird things around food. And look, people point out various things that they say are positive about the way that you eat? And how could this possibly be something that is causing a struggle for you to have somebody else say no, actually, there's another way for your brain to handle? That's right food in your life? That's right.
Dr. Karen Nelson 19:01
I think it is really important, Jane, to acknowledge that going in for that assessment, you know, meeting with one of our providers, it was determined the appropriate level of care for you with outpatient care. I think sometimes there's a misconception around eating disorder treatment. I mean, anything come up for you as you thought, oh, no, you know, what, what will eating disorder treatment be like? I don't know what tell us about that.
Jane 19:29
Yeah, I had some, I wouldn't necessarily call it a fear but just kind of a wondering because on the one hand, I really wanted to feel better. And so I was kind of willing to do whatever I needed to do to feel better. But on the other hand, I was worried about my life being disrupted significantly. So this this thought that what if they say I need to be inpatient, what if they say I need residential care? How am I going to figure that out? How is that going to impact my life? And, you know, I think I think that's kind of a, perhaps a stereotypical image that we have around eating disorder care that there's, there's only that one way to deal with it. And it's really only people who need a really high level of care who get any care at all. So going in to then receive outpatient treatment, it's yes, we absolutely can help you
Dr. Karen Nelson 20:44
100%, you said it beautifully, that there are actually all different levels of care. Inpatient is one level of care based on a variety of factors, symptom use, you know, you know, medical condition or medical stability. Thankfully, we have experts here that will determine and make recommendations for the level of care that you need to heal your eating disorder. Actually, the majority of our patients here at Melrose, about 85% of them, it is indicated that they, their treatment will be handled in an outpatient setting. And so, kind of debunk that myth a little bit and you lived that experience of like, oh, treatment happens in an outpatient setting. And so we have just for our listeners to understand the kind of the comprehensive team that we can recommend. So Park is you know, physical activity and recreation. So physical therapists are here for our patients to consult with occupational therapists, music therapists, if you are inpatient, you know, spiritual care if you are inpatient as well. So really this kind of comprehensive, you said that big word multidisciplinary, I always tripped that one up. But there's a reason why we do it that way. It is because we do believe in holistic healing. Let's move through or walk me through the recovery process a little bit, Jane? And and I would love it, if you could maybe describe for us or help our listeners know, what were some of the things you learned, or what were some of those moments that it was like, Oh, I see, I see how the eating disorder worked in there. I'd love to hear any stories about that.
Jane 22:29
So I, I have reflected a lot on those big revelations. And some of them, most of them, I think, weren't something that I could put a pinpoint on. But over time, and as they became more and more part of my daily experience, I started to see the contrast between how I moved to the world and live in my body. Now, compared to how I did, you know, much earlier in my treatment, I think one of the biggest things that I've noticed is, I don't spend my whole day thinking about food. And there is a lot of the time where I honestly don't care very much about the food part of my life. It's a thing that I do to take care of myself, I make sure I have enough to eat, I make sure that I have kind of a variety, but it's not a thing that I get massively excited about, in the way that you know, as a contrast to how, you know, fearful and restrictive I used to be, it didn't, it didn't morph into something where I have a, you know, foodie sort of approach to food at this point, I treat it as fairly neutral. It's a thing that I think that I do to take care of myself, but it's not a thing that I focus very much on. And to have gotten to the point where my body allows me to not pay very much attention to what exactly I'm going to eat. Because at this point, my body trusts me to feed it enough. And I trust my body to let me know what it what it wants and needs. So that wasn't a thing where it's like Aha, now I now I don't think about food so much. It's just over time you notice this, this background noise kind of kind of floating away. And you know, it's it's tough because I can I can totally say that. That is my experience now that I really don't. I'm really not at all preoccupied with food. And to tell somebody who has those active preoccupations know if you if you work at your therapy and you know, do your meal plans and all that eventually you can get to a point where you're not so preoccupied with food, if you tell somebody that's like, okay, okay. I mean, I felt that way too. I, I felt like anybody who said that they feel safe around a jar of peanut butter, they're either lying to themselves, or they're lying to me. I'm I am here from the future to tell you that it can happen, you can be safe around a jar of peanut butter, too.
Dr. Karen Nelson 25:34
I love that description so much. Right? That food becomes neutral, almost. Right? Like, it's the thing. Almost as you know, like, I get in and I jump in the shower, and I take a shower, and it's done. And I don't think about it again. Right? You know, before it was like, that's all I thought about. And now it's just part of my day. And I just move through the world and I eat when I need to, and I stop when I'm full. And I have what I want it. It almost feels like I had a patient describe it for me when she was like, That's crazy talk. I don't know, like, come on, Karen. Like, really, I don't. And you experienced that. Like, I don't know, when I was in the throes of my eating disorder, I didn't believe I could get to a place where I would feel neutral about food.
Jane 26:25
I think I expected that I was going to have to replace these negative, challenging scary feelings around food with an overly positive, excited feeling about food. And that wasn't the opposite of my eating disorder. For me, the opposite of this kind of fearful and chaotic relationship that I had with food is now neutrality.
Dr. Karen Nelson 26:59
It's neutral. Wow. It just feels I mean, it feels freeing, it feels quiet, it feels less chaotic. And so hopeful to hear you describe that? Well, as we talk about the process of recovery, recovery can take a different amount of time for different people, right? And the kind of in the depths of recovery are in the in the throes of recovery. I heard you use a word, you know, kind of off bike to describe some of that work as trudging. And I loved that description of just like I'm in it, I'm doing the work of recovery. Can you describe that a little bit more for us, or help us understand that a little bit more?
Jane 27:46
The middle part, I think is uncomfortable. And one of the first examples that I can think of where you're where you're really trying to deviate from, from your eating disorder behaviors. This was really, really salient for me was when I stopped weighing myself in the morning. And all of a sudden, I didn't have this data point to tell me, how do I feel about myself? How am I going to run my day? Because I don't, I don't have this, this piece of information that I usually use to, to give me that kind of external feedback. I don't have that anymore. So now I actually have to, gosh, listen to my body, I have to try to figure out what emotions I'm having throughout the day. That's really new and scary to start paying attention in a way that you hadn't been to allow things like the number on the scale, or the meals that you've prepped, dictate how you're how you're experiencing your day. Um, at other points that you know that trudging is really just trying to reframe how you think about the decisions that you're making. While you're working through treatment, even a few are going to all your appointments, which I guess is the first hurdle to go to all of your appointments. It can still kind of creep in of would it feel easier to engage with my eating disorder? Am I gonna do this challenging thing that my therapist walked me through my dietician helped me plan out for this week, or am I going to do this thing that in the moment feels easier to turn to my eating disorder behaviors? And the more you don't, and the more you choose that recovery behavior, that behavior that is in alignment with the life that you ultimately want to live the values that you actually hold aside from your eating disorder, the more you do those behaviors, that's what gets you these teeny tiny baby steps toward recovery. It's not gonna happen all in one fell swoop or in one choice. It's all of the decisions that you make throughout every day, all of these little decisions are, and little, you know, deviations from what your eating disorder wants you to choose.
Dr. Karen Nelson 30:35
I literally couldn't have said it any better. I love that description of it's each breath each moment, each time I choose recovery over the eating disorder, that brings me one baby step closer. And it doesn't have to be all or none. And it's not about perfection. It's about curiosity, and exploration. And literally trying, trying it out being curious, I say it all the time notice and pay attention. I say it again. And again. It's how I end literally every therapy session, I do pay attention, notice it, listen for it. And it is possible. I love how you said the words. recovery can be uncomfortable. Right? That it's, it's hard. And it's possible. And what do you think kind of kind of maintained your commitment to, you know, going to appointments or what maybe helped sustain some of that for you, Jane?
Jane 31:53
I loved that I had this again, multidisciplinary team, that I could bring big feelings or complicated feelings, or, you know, experiences to because I didn't feel like you know, my, my boyfriend is my my partner, he is not my treatment team. And I so appreciate the support that he that he gives in our life. But having people who are best equipped to work with you through your your specific eating disorder and other mental health challenges. I just valued that so much that I had that. That motivation that I like working with these people. That's I'm getting somewhere. I'm not there yet. But I'm getting somewhere.
Dr. Karen Nelson 32:42
It sounds like yeah, like it, literally your team could trudge with you that we're not going to, we're not going to, we're not there just when it's easy, right? Like, I say it all the time, like I specialize in messy, I specialize in hard, like I'm gonna get in there with you. And we're going to trudge together, you know, those those old ski paths that are there, I'm literally going to get on some skis and ski with you to find the new one. And that is powerful, that that healing happens in connection and in community. And that's literally what I hear you describing. And I couldn't love it any more. What do you think is different now, for you regarding food or or your body as you are experiencing recovery?
Jane 33:28
One of the best parts of my relationship with food now is I can be so flexible. It used to be that if I was going to do something other than what I had established for myself at the beginning of the week, either I'm going to have to do a lot of additional planning around that deviation. Or I'm going to feel a lot of distress around that. So having somebody suggest at the last minute Hey, let's go let's go grab something to eat. Let's go to this restaurant. That would not be an option for my eating disorder. And now it sounds it sounds silly but even things like my boyfriend and I after we pick up our groceries we stop. We stop at a drive thru on the way home to pick up dinner. And it's like well, what do you want to have tonight? I don't know. What do you feel like having I don't really care what I can I can find something to eat any place that any place that we might go. And just feeling flexible and unbothered by what our food choices are? What are we having for dinner because this is not something that's going to impact me beyond dinner. I need to have something to eat and hey, this might taste good or the sounds good. But it doesn't it doesn't take up much more space than that.
Dr. Karen Nelson 35:04
Absolutely beautifully said beautifully said. Let's talk about the reality that there are potentially people who are listening Jane, who may be struggling or trudging in their eating disorder recovery. I wonder what would you like to say to them, as they're listening to your story, any, any pieces that you'd like to share with them?
Jane 35:29
Keep going. That was that was what I would tell myself. Along the way. I have had a couple of points in my recovery, where I worried and started to judge myself, why is it taking me so long to either achieve recovery or feel confident in my recovery? I was, you know, and I'm this, this is the, the self critical part of my brain saying why, you know, I wasn't even struggling for that long. Why is it taking me so long to get out the other side so much longer, even really than I, then I was acutely struggling with my eating disorder. And, you know, my providers were very good about telling me that this process takes as long as it's going to take for each individual person. And you know, your experience is unique. And it's going to just take as long as it's going to, and so don't worry about that it. Don't worry that it's taking too long, because it's your you're continuing to do the work.
Dr. Karen Nelson 36:43
Well, Jane, I cannot thank you enough for having this beautiful conversation with me today. Thank you so much for being here. Thank you.
Dr. Karen Nelson 36:53
That's it for today. Thanks for joining me, we've covered a lot. So I encourage you to let it settle and filter in. And as I tell my patients at the end of every session, take notice. Pay attention, and we'll take it as it comes. I'll talk to you next time.
Dr. Karen Nelson 37:11
Melrose heals a conversation about eating disorders was made possible by generous donations to the Park Nicollet foundation