Support for Cacoethes (Beckie)

[one_step_closer]

Maybe you can't shake the guilt but I hope you can find ways not to let it be too big. I'm glad work went well.

[Cacoethes]

Thanks lindsay
Most of the time it's all i can think about
And the no exercise just makes the food situation worse because i haven't 'earned' it

[one_step_closer]

Sorry it's so all consuming. It's sad that you feel you need to earn food, I guess you wouldn't have that belief about other people? We all need food even if we don't exercise.

[Cacoethes]

I absolutely wouldn't have that belief about other people. Idk why the 'rule' only applies to me

[one_step_closer]

I can understand to a certain extent. I believe a lot of things about myself that I would never believe about another person. It can be hard to challenge.

[Cacoethes]

I think it's a normal human thing to not take our own advice
Seems kind of counterproductive for general living tbh
Should have evolved past that as a species already
Should have evolved past lots of things
Like having an area on our backs that our arms don't reach when you get an itch

[one_step_closer]

Yep. Do you find it hard right now to take the advice of others too when you disagree with the advice because of ED brain?

[Cacoethes]

Yeah pretty much
I want to take the advice, but it's like my brain won't let me. Which is silly because it is MY brain and can not physically control these things. Feels like a cop out. Like 'oh my brain made me do it' and taking no responsibility whatsoever. It's not ok.

[one_step_closer]

I understand that. Brains can be powerful and tricky things. It's hard when you're unwell to challenge those unwell thoughts. I guess that's where therapy should come in. I wish they had been able to support you for longer.

[Auror.]

don't mean to be rude here or to say this as an excuse, but just to point out. With EDs, there's the malnutrition component too. A malnourished brain cannot function properly. It's not that therapy can't or won't do any good. It's not even just being unwell. It's being malnourished, and think it's important to call it what it is. Brains need fuel to function.

So yea, it's shitty to not be given support. But also, it's hard when that support can't really be used effectively because you're not given the support with food to be able to have a good brain. Like the whole support thing is shitty.

But this is an ED, malnourishment is a big component of what is occurring, and brains literally don't work right without fuel. Again not saying oh don't take responsibility or whatever. But that just adds in a component to make things super impossible, and yea. Not quite the same as being unwell.

unsure where we are going with this because of course have empathy and of course angry about the support situation on your behalf beckie. just. EDs aren't being as simple as being unwell and think it's important to remember that the physical components are very serious and very dangerous.

[Bellatrix]

Also malnourishment takes time to recover from. Even if you eat more, your body will still have to fill the depletion before it can function at a normal level again. Calories are somewhat irrelevant - nutrition is more important.

That's not to say therapy cannot be done during this time, it's just going to have to take a different approach, geared more towards risk management/refeeding rather than route cause/changing behaviours, because a starved brain simply cannot process 'real' therapy until it is fuelled again. At which point, intensive ED therapy should occur (but let's be real, often does not).

I think you have said before about the ED not being a form of self harm. But I think it *is* similar in that they are both forms of communication. Somewhere a long the line, your needs likely haven't been or aren't being met. I really hope you can get yourself physically to a point where you can engage in therapy, because you deserve to be happy and not always have to battle with something.

[Cacoethes]

Thank you all

You're all right about the malnourished thing. I keep forgetting that's a thing that happens because i feel too big to have any serious affects.
Which i know isn't true, because of what happened in September. Which i really don't want a repeat of.

I think I'm just stubborn, which is why therapy wasn't really doing much.

It probably is kind of self harm. Not intentionally, but it is causing harm to me.

Thank you, i hope i can get through it also

[one_step_closer]

Sorry if it looked like I was dismissing the physical toll, I wasn't. I just don't know all the ins and outs of EDs but still want to support you. So I apologise if I am ever ignorant or say the wrong things.

[Cacoethes]

I didn't think you were lindsay, so don't worry!
And you don't need to apologise, not everyone knows a lot about EDs and that's ok!

[Auror.]

Jodie's v right and explained what we were trying to say much better than we did. Thank you for that!

Also we get you weren't trying to intentionally be dismissive or say anything incorrect, Lindsay. It's just that it's not quite as simple as being mentally "unwell." EDs very much are both mental and physical illnesses.

And Beckie, you weren't trying to just be stubbon. Your brain literally cannot function in a way to do the things without more intensive nutritional support, that you weren't given. You were essentially set up to fail, and that's a reflection on the support you were given, not on you.

This isn't to say we think you should just give up and let your ED win. But that also just leaves things in a shitty place, and we're sorry about that. We don't really know what to suggest given all the resources we know for EDs are US based. We also don't even know if that's stuff you want to look into or not. And tbf we don't even know if trying to tackle this stuff on your own is safe- we would be v v concerned about the risk of refeeding syndrome if you tried without good medical monitoring. But yes, harm management as much as possible is probably ideal if it feels doable and something you want to consider.

hope some of that made sense.

[Cacoethes]

Thanks camden
You do make sense

I am also worried about refeeding syndrome tbh
My new CC is going to find out if i can have some kind of medical monitoring, either at the GP or with the CMHT. So we'll see what happens with that.

A lot of the time, i don't want to recover until I'm 'thin enough' which isn't a thing that is ever going to happen.

[Auror.]

so, the irony of that. is no matter what weight you start at, you'll likely have to deal with gaining weight when you do decide to recover. it's just if you start at a lower weight (i.e. thinner) you'll have more weight to gain. which will actually make it take even longer and suck more lol. (also if you try to argue well you aren't technically underweight, if you've been restricting and go back to eating normally, you will gain weight, and your body will want to get back to its set point)

honestly the physical stuff involved with having to gain weight and start eating again was so awful for us, that it basically is what made us want to stay recovered in order to never have to go through it again lol.

getting some good medical monitoring sounds like a really good idea. we hope your new CC follows through on setting it up. refeeding can be really dangerous.

[Cacoethes]

That makes sense
Gaining weight is terrifying.
Like this CANNOT be my set point, surely. Because I'm still overweight BMI wise (even though i very much think/know BMI is bullshit)

It seems like my CC would definitely follow up on it, whether it's possible or not (if the GP or CMHT agree with it) remains to be seen.

I'm having a tough day. My grandad died this morning and then i had to go to hospital for an extremely unpleasant but important procedure. I keep randomly crying, I'm very tearful. Its just been a really bad day.

[Auror.]

your set point is likely much higher than whatever your weight is now given that you've been restricting and overexercising for so long and so severely. obviously not a medical human so cannot say that for sure, but it's not related to bmi at all. hope the CC follows up for you. can you follow up with them?

so sorry to hear about your granddad.

we hope you are able to rest and be kind to yourself as you process the day.

[Cacoethes]

That's true
I'm seeing CC and psych on the 7th. So next Thursday. I'll bring it up then and see what they say.
Though the psych said i should aim for a certain bmi so idk how that is going to go.

Thank you