Restricted: A novel of half-truths

by Jennifer Kinsel

  I coughed to clear my throat and swept my bangs away from my eyes.

  "Well, I've been here for a while, and it's been really hard. I want to thank all of you for helping me and I know all of you have the strength to get better. I wish everyone good luck and I hope to never see anyone again. I mean, here, at least."

  Everyone laughed and agreed we did not want to meet again in the same situation, in group therapy rooms being forced to talk about uncomfortable subjects. If I saw anyone again, I would want to see her while we were enjoying a coffee at the local Starbucks, not in a hospital.

  Technically, we were not allowed to keep in contact with others who we met while in the program, although, we found ways to slide past that rule without any questions being asked. The internet made contact readily available. Knowing that I could have support through virtual means gave me a sense of comfort. I was not sure why it was discouraged for us to keep in contact since the interaction I gave and received outside of the hospital was supportive. I guessed that someone in the past must have abused the rule in some way, by using other people for support and then unintentionally dragging them back down into the eating disorder.

  As my long stay came to an end, everyone, including the doctors and therapists, wished me good luck. Their encouraging words made me feel confident that I would not need to repeat the process I had just completed. I was proud of myself for managing to learn things about myself and new ways on how to cope in different areas of my life. I gained a ton of knowledge that would be very helpful in my future.

  But I was also terrified.

  Even though I completed the long journey, things were going to change for me. I would no longer have my days filled with hours of therapy. I was not going to see the same people day after day, nor was I going to get their support. I was going to need to keep trekking on my journey by myself without the constant watch of my actions. I was not sure how I would be able to keep pushing myself to go further on the path.

  Change was always something that I have never liked to go through. Change made me anxious and I tried to avoid it at all costs. Transitions gave me reasons to worry and I often found myself feeling sick from my never-ending thoughts. Jumping to middle school from elementary school, and then to high school from middle school was an example of my rigidity concerning change. I was certain that everyone was just as anxious as I was, wanting to puke in the mornings from the stress build-up, trying to make up excuses to stay out of school. Not everyone was as anxious and I never learned how to deal with it in a healthy way. And until the tricks I learned in treatment, I had no clue as to where to begin managing it.

  My routines worked for me, they were easy, they kept me from unwanted anxiety. Routine may have been boring but it was safe and I had always played things safe. Without the help of the program and those around me in the same situation, my world was no longer safe. I was stepping back into the real world where anything could happen. The real world was unpredictable. I knew what I would be doing every single day in treatment; however, in the real world, there were endless possibilities.

  Possibilities also terrified me since I never failed to imagine the worst possible outcome happening to me. No matter the circumstance, I was sure that things would end up horrible and it would be my fault somehow. To avoid this, I usually did nothing at all, staring at the wall as the time passed by. I would need to make a change, yet I was not sure how to make the change on my own.

  I was now alone with little support and my burdens were solely my responsibility. They always had been mine, although, I was able to pass them around, get advice, and lean on others for comfort. That was all gone and I was suddenly stranded in the same world that I had escaped in the first place.

  I no longer had my eating disorder to shy away from the dramas of every day life. In order to stay on track, I had to use the tools that I was given in treatment. The tools were foreign and did not give me the same sense of relief as the eating disorder. They were helpful, but they did not make the feelings go away. Instead, I was forced to face them and sit with myself, unlike anything I had ever done before. I was used to hiding and pretending.

  And even though I had plenty of tools at my disposal, I still yearned to crawl back to the eating disorder. I would have my freedom again and I could play the dirty game without being watched as intently. My new weight made me feel uncomfortable and I wanted to numb out like I had done before. The monster did not go away. It only became more quiet. Half of me wanted it to go away forever so I could live my life in peace without the constant whisper in my ear. The other half of me did not want to let the whisper to leave because it was like an old friend. Friends were supposed to stick together.

  In order to stay on track, I was scheduled another appointment with Dr. Pitts. I had not seen him since before the program and I was not looking forward to seeing him again, but I did not have a choice. There was a long waiting list for therapy appointments and since I had seen Dr. Pitts once before, I did not need to wait. I thought that maybe seeing him would be better than not having any therapy.

  I tried to stay positive about my upcoming session with him. Although my previous hour with him was not helpful, maybe things could change. I prepared myself for an awkward session but I hoped for the better to get something out of it.

  On the exact time of my appointment, he strutted toward me in the waiting room, wearing almost exactly what he had been wearing the last time. The only difference was his tie, and his hair looked a bit shorter.

  "Welcome back. Let's get started."

  I forced a smile on my face and followed him back to his office. He now kept a few toys on the coffee table next to the patients' chair. My eyes were drawn to a colorful little chain. It swiveled around as I moved it through my fingers and it helped calm my nerves.

  "What would you like to talk about today?"

  I thought for a moment, giving myself a chance to dig my brain for a reasonable answer. I did not have a topic prepared to talk about.

  "I'm not sure."

  "Well, you were just discharged from IOP, correct? How do you feel about that?"

  "A little nervous, but I'm ok, I think." It did not take very long at all for me to start giving automatic answers again.

  Just like the last session with Dr. Pitts, it seemed as though the time stood still and I was getting nowhere by talking about surface issues. He did not seem genuinely interested in what I was saying to him. His lack of interest only discouraged me and my response was to stay quiet. I could tell that he was not the right therapist for me. We did not match up well but there was no solution to the problem. I had to deal with it and keep trudging through the mud with no trail to follow.

  17

  Slippery Slope on Repeat

  My sessions with Dr. Pitts continued, despite my lack of interest and his unusual sense of humor. As the weeks passed by, my drive and motivation to recover was slowly dwindling. I discovered new reasons and excuses as to why I did not need to recover or why I did not need to have a meal. My excuses made sense in my head and to my eating disorder, but in reality, they were transparent and had no validity.

  I used the excuse of being tired multiple times, day after day. Since my bed was so comfortable and I loved to sleep, I stayed in bed rather than fixing myself a meal and following the plan. As I bundled up beneath the covers, I felt a slight twinge of guilt. I knew what I was doing was wrong, but I wanted to rebel. I wanted to make my own decisions and I did not need any one telling me what I was supposed to do. Although there was guilt, there was also a sense of relief. Because I was not following the plan, I could continue to ignore my feelings. Eating brought up emotions; therefore, not eating suppressed them. It was an ideal situation, at least in theory.

  Even though I felt some relief by rebelling, I also felt like a bad patient by not complying. People pleasing was my thing and not following the rules made me fear that I could possibly disappoint someone.

  A few weeks after I was discharged from the program,
I set an appointment with my dietician for the first time. She also had a waiting list because of the amount of patients coming into the center. I was not excited to start seeing yet another professional for help, but I put on a smile and dealt with it.

  After yet another hour of talking in circles with Dr. Pitts in therapy, I met with my new dietician.

  "Hey, Erin. I'm Melanie. It's nice to meet you!"

  She was a down to earth type of girl who liked to smile a lot. Her job seemed like something she enjoyed thoroughly. When I saw those things in her, it made me feel even worse for slacking off with the program and my meal plan.

  I wanted to make a good first impression. I did not want her to think that I was wasting her time or that I was being forced to meet with her. Although I still did want to hang on to my old habits, there was a part of me that wanted to continue moving forward.

  She walked me back to her office, passing Dr. Pitts’ office door on the way. Her walls were decorated with a few artistic black and white photographs, substituting for the lack of windows in the small room. I took a seat and she took hers at her desk across from me.

  "So, I hear you were discharged from IOP a few weeks ago?" She flipped through my chart as she talked, then looked up at me and waited for an answer.

  "Uh, yes. I think it was three weeks ago, maybe four, I'm not sure."

  I noticed that my chart was opened to notes about my meal plan.

  "How have you been doing with your meal plan, then?"

  My eyes drifted over to the side and I had to think for a minute. My instinct was to lie to her, or at least, that was the eating disorder's instinct. Normally, I did not lie very often, but it was very easy for me to stretch the truth when it came to anything related to the disorder.

  "I've been trying."

  I was not lying, per se, but I was also not telling the truth.

  Melanie caught on to my little trick.

  "What do you mean by 'trying'?"

  "I mean..." I could not keep eye contact with her. "Well, it's been hard. I don't have the support every day and no one is telling me the different things I should be doing. I mean, my parents might, but I don't take them as seriously." In truth, my food intake was not what it should have been. Day by day, I had been dropping small things from my meals so that in the moment, it was not a big deal. But those little things added up quickly and I was soon not far from where I originally started.

  A look of questioned concern appeared on her face for a moment. She pulled open one of her desk drawers and found a worksheet that was very familiar to my eyes.

  "Take a look at this. Tell me how much you've been following."

  The paper was a worksheet explaining the program's meal plans: basic and standard. I was placed on the standard plan, meaning that each of my meals had one extra item compared to the basic plan. Other than that, they were identical. Underlined on the sheet were a few reminders:

  Dessert every day! Everything is OK in moderation.

  Don't forget your caloric beverages! (Gatorade does not count.)

  Space out your meals appropriately.

  Dessert was not that big of an issue for me. I did not mind enjoying desserts and I thought it was funny that I was required to have them when most other “normal” people avoided them like the plague. What I hated were the caloric beverages. The calories in drinks seemed to be a waste to me. If I needed calories, I would have much rather eaten them than drank them.

  I realized that what I was eating was pretty far off from what I should have been eating. I did not notice how many items I was missing until it was pointed out to me by Melanie.

  "I'm actually missing a lot, I guess. I kind of wanted to lie and say that everything is fine and I am eating 100%, but I'm not." I was surprised at my honesty, especially since it was our first meeting. The part of me that really did want to recover decided to overtake the eating disorder side in that moment.

  "Well, thank you for being honest. I know it can sometimes be very tempting to lie about these things." She was right. "Can I take your weight?"

  I nodded, then stood up from my chair, slipping my shoes off at the same time. I walked over to the scale sitting in the corner of the room. I had not weighed myself since I was in IOP and my heart began beating faster in anticipation. My feet stepped on the scale and I waited for the beep to sound and the number to appear in bright red numbers.

  As the machine calculated my exact weight, I closed my eyes in anticipation. My weight was supposed to stay stable if I did not want to face the possible threat of going back into the program. The number flashed on the screen and I let out a sigh.

  "You've lost some weight. A pretty significant amount, I would say." Melanie jotted down the numbers on my chart and sat down in her chair again. My head dropped and I, too, took a seat.

  "What do you think about that?"

  Since I had been telling her the truth throughout our meeting, I decided to stick to the truth and give my honest answer.

  "Honestly? I kind of like it, even though I know it's not a good thing. Like, I want to stay at my goal weight because that's the healthy choice, but my eating disorder tells me that I need to lose the weight. It's a battle every day and I never know if I'm making the right choice."

  "Ok, well, thanks for letting me know how you really feel. I know it's not easy. But I am pretty concerned about the amount of weight you've lost since your discharge date. I'm going to have to talk to Dr. Hoffman about this. Admitting you back into IOP may be the next step."

  I did not like that answer. I did not want to go back into the program. I already knew what was being taught and I would have nothing to gain. I could gain the extra pounds in an outpatient setting, I thought. I was really lying to myself, only I could not see that I was lying. Deep down, I knew that staying in an outpatient setting would not help me any more than staying at home. If I slipped that far in a matter of weeks, I could only imagine what would happen without a quick intervention.

  After my appointment with Melanie, I chose to go to Starbucks and relax for a while. I always carried my journal around with me in my bag, and I liked writing while I sipped on a hot cup of coffee. I thought back to our conversation and the fact that she would be talking to Dr. Hoffman about my weight loss. A feeling of anxiety mixed with anger started to brew within me.

  My anxiety arose from the simple fact that a decision was out of my control. Dr. Hoffman had the last word, he was the boss. Technically, I could refuse all treatment, but I knew that was not an option. I knew that if I refused it all, I would surely never dig myself out of the hole. I did not like the fact that he held the control, and I almost surely knew that he would agree with Melanie and recommend the program again. They were professionals and they had seen every trick in the book to avoid treatment. Any excuse that I could give would not be good enough. They were smart and they wanted what was best for their patients.

  My anger came about from judging my performance between discharge and meeting with the dietician. I was angry that I could not stick to the program, but I was also angry that I did not lie to avoid any mention of going back. If I lied, I would have been able to dive deeper back into the sickness. A small part of me wanted that life back, even if I knew it was a horrible existence. My lack of ability to follow what I should have been doing frustrated me.

  I felt as though my brain was two mismatched brains cut in half and sewn back together. The eating disorder was one half, the half that was evil and wanted me to self-destruct. It did not care if I headed down a path with no exit. The other half was my true self and knew what was wrong and right in reality. I was never sure which side I was supposed to follow. It was easy to think, "Eating disorder, just shut up!" in a moment when I was feeling confident and happy about myself. But when it spoke to me, there was nothing harder than trying to ignore it.

  Slipping down the mountain I had just conquered was discouraging and came as a surprise. It was easy to make one minor slip, maybe two, but then they added up and
it was no longer one tiny mistake. I had climbed to the top, looked around, and slid down to the bottom again. The slips were easy to ignore and it was easy to convince myself that it was not a big deal. By the time I caught on to what I was doing, it was too late and I had slipped too far down. I only had one logical choice: climb my way back up the mountain again.

  18

  Nothing Changes if Nothing Changes

  Before I had a chance to think too long about my situation, I was back in the Intensive Outpatient Program at Stafford Hospital. Dr. Hoffman, Melanie, and Dr. Pitts decided that it would be best for me to go back for another round. Of course, I was not happy about their decision, but I agreed to go any way. Again, a lot of my mind knew that the right thing was to stay on the healthy path, but I struggled to let go of the destructive behaviors. They were safe and familiar and change meant that I would need to survive the inevitable feelings of being uncomfortable.

  I was embarrassed that I needed to go back to the program in the first place. I thought that a second try meant that I had failed, and failure was never an option for me. It never occurred to me that recovery was often a difficult process and was rarely a straight journey to freedom. In my head, since I did not get it right on the first try, I was a disappointment. The last thing that I wanted to do was to face Dr. Serrano and Dr. Reed. I was afraid that they would judge me for coming back, for not being able to handle the disorder outside of the programs’ walls.