Day 5 Intensive: Group Therapy Experiment

(Long post this evening...my apologies in advance! Today was packed with all kinds of recovery goodness.)

During a recent moment of temporary insanity, I happened to mention to Dr. Joe that I wanted to search for an eating disorder support group in my area. Well, as you can imagine, both Dr. Joe and LA latched on to this idea like dogs on bones, so I've been receiving some subtle "encouragement" to attend one this evening at a local eating disorder outpatient clinic.

I do not consider myself a "group therapy" kind of person (if there even is such a thing). I have always had it in my mind, perhaps unfounded, that my situation is somehow unique. Well, let's face it: it is not. There are millions of people out there struggling with various eating disorders, and while our individual situations differ, there are some underlying issues most of us struggle with universally. We might as well bond over them while lounging on some fluffy pillows.

Starbucks coffee has suddenly become my security blanket this past week (I don't drink it regularly, yet keep randomly finding myself in their drive-thru on my way to therapy and nutrition appointments), so I feel the gravitational pull towards the white and green sign on my way to the support group. I wonder for a moment if a latte is illegal contraband in the eating disorder support group world. I decide I don't care and that I will just own my role as the support group Bad Influence right from the start.

On the way to the clinic, I try to "have an open mind" (since Mama K had just texted me that motherly advice several minutes before). I try to really think about why I have self-indentified as a Group Therapy Hater, and here's what I came up with:

1. I am certain I will be the largest one in the room (have YOU ever been in a room full of anorexics and felt skinny? Just sayin'...).

2. I read on the clinic's website that group members are not permitted to talk about specific urges or behaviors while in the group setting. I'm not sure how I will be able to relate to the others if I'm not allowed to speak of the behaviors and patterns that got me to this point in the first place.

3. I'm not convinced that other eating disordered individuals are the best friend choices for me right now. Imagine two recovering anorexics going out to dinner together. The mind reels, does it not? I imagine calling another ED girl and telling her "I am tempted to skip eating all together today" and hearing the not-so-healthy response: "Oooh! Me too!". Supportive, yes. The kind of support I need? Probably not. And the last thing I need is to be supporting someone else through their own struggles when my own recovery is still spotty at best.

Despite the lack of signage at the eating disorder clinic, there is no mistaking that I have arrived at the right place. A skeletal girl several years younger than me is slouching on a sofa, arms crossed and looking severely depressed. Another girl with a head of unruly brown curls is sitting on a large pillow on the floor, wearing a pair of ripped Express jeans that I instantly decide I want. To my surprise, a thirty-something man wearing athletic gear is sitting in an armchair. Two other women greet me with smiles. It is somehow immediately evident to me that they are counselors and not patients, though I can't quite put my finger on it. Perhaps it is indeed their bright smiles; they appear too happy to be battling such a draining disorder.

I take a seat next to Skeleton Girl, gripping my Starbucks cup tightly and praying no one makes me throw it away. Cute Jeans Girl takes a swig out of her own Starbucks cup just as I catch her eye. I smile at her, and she smiles back with instant understanding. Coffee appears to be acceptable in ED support group. I guess they are just happy we are putting anything at all into our bodies.

When the clock hits 6:30, Counselor A starts by asking everyone to share their name and a little about themselves. Cute Jeans Girl is clearly a regular, as the counselors joke around with her and ask her about recent developments in her life. When it comes to me, I say the words I never thought I would say to a group of people, forming my introduction from the cues I picked up from the others: "Hi. I'm M. I'm about three months into recovery from anorexia and working independently with a treatment team. I'm still in the beginning stages of refeeding and just took a two-week leave of absence from my job as a college administrator to do some intensive work with my team".

Cute Jeans Girl smiles at me again and says "You are so lucky you got to take a leave. I had to resign from my job to do six weeks in an inpatient program." I nod, knowingly. But in reality, her statement scares me to death. Could that have been me? Certainly I would have never let myself drop to that point...

In both of my jobs (as a college administrator and fitness instructor), I have been trained to build community. I am used to being in the leadership role within a group such as this; typically I am the one asking the questions, facilitating the conversation, seeing to it that the participants are engaging in conversation. When Counselor B's (who we later find out in an intern) opening question is met with awkward silence from the group, I forget where I am and automatically take my routine position as the first to speak.

When I finish providing my input on the "gray area" of recovery (I will blog about this another time...it's a topic I've been wanting to write about soon), Cute Jeans Girl is nodding, wide-eyed.

"Oh my gosh, I can so relate to that. That is my situation exactly." As she piggy-backs on my response, I decide I like her and that we totally get each other. I make a mental note to befriend Cute Jeans Girl after the meeting is over. Perhaps we can start hanging out at Starbucks together before these ridiculous meetings.

Cute Jeans Girl and I monopolized tonight's support group, sharing stories and relating well to one another in between taking sips from our matching Starbucks cups. Counselors A and B were soaking us up, enthusiastically throwing ideas and support our way. When a moment of silence finally crept up, Guy In Fitness Gear randomly stood up from the armchair and asked "Can I leave now and come back another time? My anxiety is really kicking up here."

I saw a flash of confusion on Counselor B's face, but she quickly recovered. "Certainly," she says. "You are welcome to leave at any time. We hope you return."

He bolts for the door. I suddenly remember why group therapy freaks me out.

Cute Jeans Girl and I stare silently at the floor, probably both wondering if we had set off the crazy guy's anxiety button with our conversational tennis match. Counselor A comes to the rescue by asking Skeleton Girl how she is feeling, pointing out that she has been very quiet this evening. Skeleton Girl says she is depressed, has no motivation, and keeps spiraling into the same cycle of starvation. She feels extreme guilt, and makes mention of the fact that she is a high-achiever in all other areas of her life, aside from tackling this disorder.

I can relate. I tell her about the frustration I used to experience when Dr. Joe and LA would give me such huge pats on the back for achievements that seemed so trivial compared to others in my life. For years I received positive feedback for things like earning a Master's degree, receiving a promotion early in my career, succeeding in athletics, winning prestigious awards. When the positive feedback was suddenly tied to such minute tasks as eating a meal or going a day without purging, I felt my life had been reduced down to such insignificance that it was not worth the effort I was putting into it.

I'm not sure what it was, but something I said resonated with Skeleton Girl. She finally looked up from her lap and gave me a half-hearted smile. So that's what group therapy is all about. Suddenly, I understood.

After an hour and a half of eating disorder talk, I was more than ready to jump off the couch when Counselor A decided to wrap things up. I had already been in to see both Dr. Joe and LA earlier in the day, and I had officially reached my therapy threshold. I tossed my coffee cup in the trash and bolted out the door. As I was pulling out of the parking lot, I realized I had left without exchaging information with Cute Jeans Girl (a potential new friend! I love those!). I pulled back into the parking lot, but she had already left. I instantly regretted not talking to her after the meeting.

Shit. I guess this means I will have to come back and attend another one.

So the Group Therapy Experiment was ok. I will rate it an even-keel five on a scale of one to ten. On the way home, I went over the conversations in my head. I did get some positive reinforcement and ideas from the counselors and other group members, even though Cute Jeans Girl and I hijacked the conversation. While I prefer my individual sessions with Dr. Joe and LA, I decide to file the support group away as a potential tool for the future. I don't think I will ever become a card-carrying devotee, but it may provide a good sofa to sit on when times get really tough or I feel the need to bitch about the latest ED-inspired challenge.

As for my other appointments today, they can best be described as "eh". I was not really in a mood to talk a lot after an ED episode last night, and Dr. Joe had decided to really pull out the big guns and "get serious" with me today. This was followed up with a body image/ body distortion conversation in LA's office, during which I outright denied my body dysmorphia and explained that I still think everyone is lying to me about how skinny I am. Over the entire weekend, I squinted to see what others are seeing, but just couldn't. I guess it really doesn't matter, as I've been told again and again to just trust the team, but I still slip back into this thinking from time to time and have to be pulled back into the boat.

Both appointments were followed up with phone calls, which is never a good sign. About an hour after leaving LA's office I had to call her after a "binge" (again, relative term...) in my kitchen. I had come home from both appointments emotionally drained and slightly hungry, which led me to rip through the refrigerator and cabinets in search of anything my body craved. I had downed a few flaxseed tortilla chips, a string cheese, some hummus, and a small container of caramel Greek yogurt and was instantly filled with enormous guilt.

About an hour after that, Dr. Joe called and we had a follow-up conversation about our earlier appointment. He had told me during the appointment that he can tell I am struggling despite working hard at recovery, and that he thinks I may be in a little bit of denial about the potential severity of the current medical situation. I tearfully told him this made me feel like I am failing despite my efforts. He corrected me by saying (in his calm and soothing voice) that there is a difference between struggling and failing, and that I am in no way failing or letting him down. This was music to my perfectionist ears, and gave me the motivation to keep fighting.

As for tomorrow, it's Scope Day. Procedure will be at 3:00 tomorrow, and I will be out cold for the rest of the day. I'll spare you the incoherent thoughts and stay the hell away from the laptop until the drugs have worn off.

Wish me luck...