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Saturday, 26 February 2011

8. MBT for Eating Disorders?

Good grief it's Saturday. That's another week that has raced past me in a fraction of a blink of an eye. Slow down life!
I'm feeling agitated by the speed of which I am letting life slip through my fingers.
How can days feel so endless and yet weeks pass so quickly? How can I think in one moment that I can't possibly get through this moment..and then, the next moment, wonder where the hell the previous moment went? My head is racing today...gallopy gallopy gallopy...puh-dun-puh-dun-puh-dun-puh-dun (my attempt at alliterising a speeding horse/head..didn't really work did it? Nah).

A brief update of yesterdays teaser: Will she or will she not go to see her Care Coordinator (K)?...
...The answer being yes. I did go. If I can recall the details from the recesses of my mind (there are no guarentees) I will write more about this later.

I've a couple of bloggy ideas that revolve around Mentalisation Based Therapy (currently being touted as an effective treatment for BPD) for eating disorders. But I want to find out a little more before I start spouting on it (I'm something of a research-o-phile!). It interests me, but I'm not sure if that's in an "oh, this might help me" or another manifestation of me avoiding engaging with "evidence-based" treatment to instead continue a futile search for alternative new-fangled ideas or even old ideas which just don't have the evidence base to prove their worth (for the record, I believe I have engaged with treatment (time and again) but that it has not been helpful for me and in some cases has been detrimental E.g. Evidence-based inpatient treatment- sectioned for a year; deteriorated physically and psychologically; taken off section; discharged; deteriorated further). I just passionately believe that there is another way of doing things but it's overlooked for myriad reasons (one not so small reason would be that old chestnut cost-effectiveness and another risk assessment...oh and the age-old "because that's how we've always done it").

Just to remind myself a few quick memory cues:
Mentalisation (Fonagy and Target (1996/97)
MBT (Bateman & Fonagy 2006)
New Dawn Unit Bierley, Bradford
..." the infant learns that its mind does not mirror the world; its mind interprets the world. This capacity is referred to as mentalisation"
Eating disorders as disorders of self?..

Sorry, I know that all makes no sense but my memory is akin to that of a demented goldfish so it helps to have a few jottings (and jottings of jottings and more jottings of jottings and..ad infinitum...did I mention I over-analyse everything?!)
BTW, if it does make sense to you and you have any offerings/ideas/experiences with MBT I'm all ears (eyes)!

Until later... ;)

Friday, 25 February 2011

7. Do I sound glib? I'm not.

"Tomorrow's another day". Yup, that's usually the way things go. Folk say that to try to stir a little positivity in you. In honesty, it always seems to have the opposite effect on me:
 "Oh how wonderful. You mean I get to have another day like this one?..Hang on, I must go get the celebratory bunting put up and don my best outfit and hat for the occasion..Super, smashing, grrrrrrreat"...Bah.

Meh: that's how I feel today, just meh.
I've an appointment to see my Care-coordinator/nurse therapist at 1pm. Mainly this will involve me ejecting my weekly build-up of frustrations and hopelessness all over her. If I go that is, and do not fall prey to my bed/sofa/floor (pretty much anywhere that would pass as somewhere to drop and sleep). I'm so tired I fear I may even awake to find myself with QWERTY etc imprinted on my forehead (oh, I guess it would be YTREWQ actually wouldn't it? Either way, I'm sure it's not the pinnacle of high fashion this season).

I must be immune to caffeine because my ultra-strong morning coffee (which almost holds my spoon up straight it's so damn strong) seems to be having little -if any- effect on my ability to hold myself up straight. I swear my hunch-back is but a matter of months away..SIT UP MEL!..I'm trying, I really am, but my stomach muscles seem to insist that it would be far better if the bottom of my ribs were able to rest on my hipbones and scrunch my abdomen up in a valiant attempt to achieve this. Lazy.

OK, I really must stop slagging myself off. Why is it so difficult to cut myself some slack? I can hear K's (Care-coordinator) voice in my head, justifying my physical crappiness...but still, it all sounds like excuses to me. K: "you're not well Mel, you're physically weak, your bloods are a mess and you're at a dangerous low weight"..that's what she says. In my head though, I hear "you're weak, (make some effort), sort your bloods out (make some effort), you're underweight (make some effort)"...Alas the effort required to address these aspects seems far beyond what is currently available to me...Perhaps (most definitely) I choose to put what little effort I do possess into my entirely inappropriate and maladaptive "coping" mechanisms ('scuse me while I choke on this medical dictionary I just swallowed, ack) instead of ploughing it into something that may (or may not), long-term (what is long-term...will it arrive before I die?) be of greater benefit to me (or so I've heard).

It's not that I don't think "recovery" is a bloody marvellous idea. But the fact is, the very thought of it terrifies me to hell and back.
When folk talk about how recovery is this great thing that will set you free to live your life and enjoy everything the world has to offer, I'm pretty sure they're not trying to instil the fear of God into you. They are encouraging you, helping you, urging you on with their positivity...
If only I were not so shit-my-pants-terrified of the  "live your life" bit and "everything the world has to offer". I know, call me ungrateful, but all this talk of "all the things you will be able to do" and how "the world will be your oyster"...well, I tell ya, it's guarenteed to have me running for the hills/fridge/toilet bowl/bed.
With me, "recovery" (I use the term as a very loose concept as I'm not entirely sure what it means for me) is less about thinking big and looking to the future and more about thinking teeny-tiny mini-steps and attempting to stay in the "now".
All I know is that I could be sat here ten years from now, wondering where those ten years went and still in the same place physically; emotionally; psychologically. That scenario is uber-easy to imagine. Or, I could be doing whatever it is "recovered" folk do. That scenario is totally alien to me: it doesn't feel right, it doesn't feel exciting, it just feels overwhelmingly terrifying and unreal. The other alternative of course, is that I could be digging up the daisies: Dead. Even this third option feels less threatening than "recovery" (or the consensus view of what "recovery" means in the world of eating disorders).

Chronic, refractory eating disorders. Now there's a subject that should be more thoroughly investigated.
 I think it's great to hear about the advances in family-based therapy for adolescents and programmes to identify eating disorders quickly enabling treatment to be swiftly instigated. But I worry (and I feel) that those who have been bumbling along in the system for many years are being left behind. Even the reportage of eating disorders in the over 30s most commonly includes headlines like : "Increase in Adult-Onset Anorexia". I think the more likely explanation is that these adults have been struggling for many years with an eating disorder, maybe they've even been treated by services before. The unfortunate reality is that many of the numbers that make up the "increase" will in fact be the same people who are presenting at ED services again after previously giving up on the help available.
The more unfortunate thing is that precious time will be wasted going over the same things, the same approaches, the same, same, same treatment that did not work last time (or the time before, or the time before...), but due to  (the ever-diminishing) resources there is little new being tried in the way of treatment for anorexia. Every supposedly new piece of research I have seen published recently is just going over old ground. I know there is a need for repeated studies of the same aspect to collect data to support evidence-based practice but where are the new; truly new studies that  might enable change in a field which, for me at least offers little hope. For the record (given my terror of recovery), I have not always been so averse to "living", but for the life of me (ironically) I can't see a way of living without the eating disorder. And I feel I have exhausted the help available from the current services (to such a point that my consultant rarely sees me except when he absolutely has to e.g.when I'm an inpatient..even then it's hit and miss. To be fair i think he'd make a better banker than consultant - empathy's not his strongest trait!)
I've seen with my own eyes over the past 18 years that although eating disorder services are painted as being patient-centred and collaborative, in my experience a lack of resources and understanding (even from those higher echelons of the consulting world) and also an aversion to risk-taking is stunting the potential for better services for all. A bit more out-of-the-box thinking is required. Particularly when it comes to chronic refractory illnesses. The "revolving-door syndrome" is not a myth. Each of my 10+ inpatient stays (at 2 seperate ED units in different parts of the country) there has always (without fail) been patients there that I knew from previous admissions. Outpatient and aftercare appears to be lacking. I've read much to back up this claim. I have ideas...but will share later as I fear this post has rambled past it's point already (whatever point it may have had).

Oh I'm just frustrated at being so stuck. I think I should be able to rationalise my way out of this. But I can't. Because it turns out that it's not rational at all. Any of it. My intellectualising will get me nowhere except more wedged in. The problem is not with services, it is with me. I just have to accept that. It's down to me. Now there's a scary thought, because currently I'm about as productive as a peanut.

Thursday, 24 February 2011

6. Toxic Mass

It's bath day today. Definitely. I fear for the looming ecological disaster if I don't make the effort. I have no desire to be responsible for the death of any bird who should be so unlucky as to find themselves in close proximity to my oil-slick hair. Eugh. Plus, I swear I should have toxic hazard stickers displayed in prominent positions about my body.
Damn, it's times like these that I wish my shower worked. As it is, my choices are to 1.) have a bath or to 2.) die of hypothermia in the icy spray (some may call this "refreshing" - I would call it "madness"). Ergo, bath it is.

There are so many reasons why bathtime is not funtime...Perhaps I will entertain you (/myself) with them later...God I love a cliffhanger..

Wednesday, 23 February 2011

5. One Day I Might Blog About Something Interesting.

Can't think. Head's numb. Inspiration won't come...blah blah bleugh..
Today is one of those days that's drained me before it's even really began. I can hear my bed whispering sweet nothings..
"come back to me Mel, you're weak and tired and I'm warm and comforting...Mmmmm...warm. Mmmmm....sleeeeeeeeeeeep. Let me hide you from the world and take you back through the portal to your own imagination...Come rest your bones dear..". Oh bugger off.
It's tempting, I admit. I feel like I've been mauled by that gang of ruddy wildebeest during the night, again (I don't know how they get in here, but I shall be taking precautions tonight to ensure that they don't turn up looking for a night of fun and frolics at my expense ever again, yes I will: have gaffer tape - will seal). Oh well, at least they didn't trash the flat in their stampede. I guess you have to be grateful for small mercies. Amen to that.

As for the rest of the day, well, where to start? The excitement of it all has rendered me mute...

Tuesday, 22 February 2011

The point of awareness - ED Bites

The point of awareness - ED Bites

The media parades about some "facts" and "figures" about eating disorders as if they were gospel. If only they could agree on the same "facts" and "figures". Unfortunately, mostly they are just interpreting somebody else's interpretation of data yielded from research which may itself have little basis in reality.
Chinese whispers..

3. Portals

Allegedly, a change is as good as a rest. With that in mind I've ditched the original working title of my blog and reverted to my usual interwebz identity. You see, the unfortunate side-effect of having a blog named "Can't Think Won't Think" is that it seems to have had some kind of self-fulfilling prophesizing effect on me, in that I really couldn't think of anything to write. I think because I was in fact: Just. Thinking. Way. Too. Much! So all-in-all, a crap title that wasn't even true anyway: I can think, and do so way too much on a regular basis. I think it's the "sharing" I have more problems with!
Anyhow, at least nobody would have noticed, as thus far I believe I'm the only one to have visited...aah, glorious anonymity.
So, yeah...I'm just really faffing about at the margins of this particular blogosphere at the mo'. Messing around with the technicalities of it all and generally doing my best to avoid the nature of my blog (or eventual nature of my blog), whatever that might be.
I'm not a newbie to blogging per se. Xanga still hosts my 'other' blog...I'm still not sure why I felt the need to create a new place for myself....Just, because. Maybe I'm just running away from what I judge to be a commitment. Or perhaps it's an attempt to break free from the identity I created for myself and to push the boundaries (that I imposed) of my life to encompass something more than who and what I am right now. I think I mentioned previously that I do have a leaning towards writing introspective shite...

Today
At present I'm sat, slumped over this here computer, typing fairly aimlessly (as I imagine you - if, indeed there is any 'you' there- have been quick to notice!). I was up late today (11am) as last night (or early this morning should I say) I dallied beyond what was ideal from the time I took my zopiclone to parking my head on my pillow. So, incoherently, I spent half the night with my head down the toilet following an equally incoherent  bout of bingeing. I was mortified this morning when I checked the cupboard and realised I had indeed cleared myself out of 4 cans of tinned fruit...I don't know why in particular the tinned fruit mortified me..but it did. I think it just stood as a clear example as to the mindlessness of it all: Easy to binge; easy to purge. But crucially eats up time to think and prevents (or defers) the vivid (un)reality of my dreams. Dreams...aah, so terrified that I'll not escape them but so disappointed when I realise that I have. In reality I struggle with a depression and crawl through the mundane, but in my dreams I feel the high of terror and the adrenaline rushing through me. I wonder where the middle ground is and about the addictive qualities of this rollercoaster...or perhaps that's just me, manipulating the psych'-speak to fit my own agenda? Would I even want the middle ground if I found it? What does the middle ground even look like/feel like? Why does it scare me so much?
Oh glory be. Everyday I hit new levels of shit-spouting..such a talent you know.
I fear I'm starting to grow roots and so, for fear of becoming stuck at my computer all day (when I have so many more worthwhile things to do *sarcasm*..actually, I do have other things to do and fear the problem may well be that I am stuck in my head rather than merely being stuck to this chair) -and developing a hunched back to rival that of Notre-Dame's most famous inhabitant- I'll shimmy (crawl) along to my boudoir (tip) and hope I land among the "clothes-fit-to-wear" pile as opposed to the bed/portal to the other side. Again, my teeth are badgering me to rid them of the toast debris (yes, I'm anorexic, yes I eat breakfast with no compensatory behaviours...I've been living off this achievement for years now and really, it's time to do (more) or die. Gosh, I really do not like myself (actually, that's not as revelatory as it sounded).
I can just tell this is going to be another post I'm going to want to delete. But I won't...maybe I just like tormenting myself.

Thursday, 17 February 2011

2. Taking Responsibility

Pleeeeeease, if there is a higher being out there, somewhere, could you enable my stroppy computer to stay alive until I've at least  finished and posted this entry? Pretty please? Grr....I think it takes it's lead from me..i.e. temperamental!

I wasn't entirely sure I'd make it back to blog here again. Not because anything drastic or untoward happened yesterday (no more than usual anyway), but because I was a little overwhelmed with a nasty case of paranoia and...erm..well I can't quite put my finger on it, but this 'putting yourself out there' lark (no matter how anonymously) feels excessively revealing. I spent the rest of the day resisting the urge to delete this Blogger account and withdrawing once again back into my familiar status of 'hibernation'.
But, it's a new day and the part of me that likes to poke my head above ground every now and then has won the day (or hour at least), thus here I am...I know, you're all thrilled (all 2 of you - whoop!), I can tell by those deadpan faces and strumming fingers..

I perhaps might have posted again last night, twas it not for the fact that the entire fridge launched itself at me and invited me to "have a ball"...which I duly did. God, I loathe bingeing..and yet at the same time I need it like the air I breathe - or so it seems (although I know this is bollocks - of course..but try telling me that when my hands are busily stuffing enough food into my mouth to feed a small African nation). It's like an itch that won't go away until it's been well and truly scratched; the difference between a head bursting at the seams and a stomach bursting at the seams - the bonus being that the stomach contents can be ejected and thus bring at least momentary relief from the ever-present feeling that I am but a second away from spontaneously combusting: given the overwhelming thoughts that bludgeon the inside of my skull daily.
Oh, how very poetic and such feckiness. I do talk shite...if you hadn't noticed.
I'm still not 100% sure what this blog is going to evolve into (if anything). It's perfectly possible that it may in fact devolve into nothingness...I myself have a secret wish (ok, so not that secret really) that perhaps I could devolve myself into nothingness. Given my choice (such that it is) of mental illness I believe I have a shot at reaching this..er..goal.

So, I referred to my eating disorder. "My" eating disorder...as with most things I question and analyse in the finest detail what I think and feel (and -as is obvious to me now- what I write too). Do I possess my eating disorder? I think it's more likely that I am in fact its pet and it plays with me when it feels the need to be entertained: "Oh goody, a weak-minded human to wreak havoc on. Best fun I've had in....oh, since yesterday when I had her receiving a good bit o' splashback in the eye thanks to my pal 'the toilet-bowl'.
No no no, I (magically) know what you're thinking, but I do take responsibility for the anorexia (binge/purge subtype to be precise..and let's face it, the psych's love a bit of labelling wherever possible). I know that at the end of the day, when all's said and done, when the sun has set in the sea and...erm..anyway, yes, I know the buck stops with me. Somehow -whether over, under, around or through- I have to get to the other side of this big, fat blockage: 'anorexia-twinned with bulimia'. And on the way I'll hopefully slay a few other demons like 'anxiety', it's best mate 'depression', that bloody hanger-on 'social phobia' and maybe, just maybe I might even be able to deal with my penchant for 'avoidance', because he, I believe has the key. Somehow I need to live in the moment long enough to wrest that damn key away from him and unpadlock my life! Oh dear, I think I need to sit down. Oh, I am.

If only I were so good at action as I am at whittering on and rhetoric. There's a thought.

As you see I am merely skirting around subjects at the moment...just until I feel a little more at home.

If you have somehow found yourself here at my humble home, well, Hi and welcome. I hope you're well :)

That's it , my head's run dry.

Wednesday, 16 February 2011

1. Hello

Can't Think Won't Think: because sometimes I can't and sometimes I won't...and mostly because I can't tell the difference.
And because sometimes I think I can and sometimes I think I will...but mostly I walk in circles and arrive back at Can't Think Won't Think.

So yeah, welcome to my blog, I'm sure you're none the wiser what it's about...well, join the club, because I'm clueless!

Forgive me if I'm a little presumptuous, but seeing as you're here, I guess you might like to find out who the hell this rambling twit is?
Go on then, I shall furnish you with some detail (please, try to quell your excitement) and perhaps it will give me some idea as to the direction I want to take this new and shiny endeavour in (I realise I should have planned this a little better..Pah! to spontaneity I say).

I've a little over thirty years experience on this planet, the past 18 or so of which have been eaten up by bulimia and anorexia, anxiety and depression. Oh, the glorious world of labels and diagnoses, which in turn lead to a vast array of interesting 'professionals' and their vast array of differing theories on how to haul you out of mental illness and back into the world at large.
I'm not sure the world at large is ready for me...I know I'm not ready for it (this is obvious to me as I sit here in my pyjamas, shaken-handedly typing this, hair still fashioned into a knotty mess -courtesy of herd of wildebeest who blatently trampled me whilst asleep, the buggers-amidst many a-scribbled on pieces of paper, on a carpet that cries out in desperation for an introduction to Mr Hoover next to a window that will not see the sheen of window-cleaner, as the grime somehow keeps the world at bay and provides an extra layer of security (I secretly wish it were clean and spangly...so perhaps 'tis just laziness on my part)).

It is midday. My teeth are pleading with me to give them a good scrubbing and in a pique of rebellion I may even drag a brush through my hair in a one-fingered salute to those damn wildebeest (every night?!).
Well, it's a start.